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.

Objective:To explore the value of 18F-fibroblast activation protein inhibitor (FAPI) PET/CT in the assessment of early-stage graft fibrosis (S1-S2) after liver transplantation (LT). Methods:From November 2021 to April 2022, 17 adult liver transplant recipients (12 males and 5 females; age (52.6±7.9) years) in the Affiliated Hospital of Qingdao University were enrolled retrospectively in this study. All 17 patients received laboratory examinations, FibroScan, 18F-FAPI PET/CT and liver biopsy. According to the Scheuer scoring system, hepatic tissue was divided into no fibrosis (S0) and early fibrosis (S1-S2). Independent-sample t test was used to compare SUV max between two groups, and Mann-Whitney U test was used to compare liver stiffness measurement (LSM). ROC curve analysis was used to evaluate the diagnostic efficacy of LSM and SUV max in the early fibrosis of liver grafts. Delong test was used to compare the difference of AUCs. Results:Among 17 adult LT recipients, 11 were in stage S0, 5 were in stage S1, and 1 was in stage S2. There were significant differences in LSM and SUV max between no fibrosis group and early fibrosis group (LSM: 5.4(4.7, 6.6) vs 12.9(5.6, 19.9) kPa, z=-2.01, P=0.044; SUV max: 1.7±0.8 vs 3.9±1.6, t=-3.14, P=0.019). The threshold value of LSM in predicting early-stage graft fibrosis was 8.2 kPa and the AUC was 0.80 (95% CI: 0.54-0.95), which was 2.0 and 0.92 (95% CI: 0.78-1.00) for SUV max respectively. There was no significant difference in AUC between the two tools ( z=0.80, P=0.421). Conclusion:18F-FAPI PET/CT can precisely evaluate the early fibrosis of allografts, with the similar diagnostic efficacy with FibroScan (LSM), which is expected to be a new non-invasive diagnostic tool for predicting the early-stage of graft liver fibrosis.

AIM To evaluate the pharmacokinetic properties and bioequivalency of Yexiazhu Formula Granules and Decoction.METHODS Twelve rats were randomly assigned into two groups and given intragastric administration of the solutions of Yexiazhu Formula Granules and Decoction(0.428 2,2.000 g/kg),respectively,after which blood collection was made at 0.083,0.167,0.25,0.5,0.75,1,2,3,4,8,12,24,36 h,UPLC-MS/MS was adopted in the plasma concentration determination of gallic acid,corilagin and ellagic acid,and main pharmacokinetic parameters were calculated.Subsequently,the bioequivalency of these two preparations was investigated.RESULTS No significant differences in AUC0-∞,AUC0-t,MRT0-∞,MRT0-t,t1/2,Tmax,CL and Cmax were observable between the two preparations(P＞0.05),whose Cmax,AUC0-∞ ratios or logarithmic mean differences accorded with bioequivalence standard at the 90%confidence level.CONCLUSION Yexiazhu Formula Granules and Decoction demonstrate approximate pharmacokinetic properties and display bioequivalency.

Intersphincteric resection (ISR) is an advanced sphincter-preserving surgery for low rectal cancer. Accumulating evidences from clinical studies indicate that ISR can spare some pati-ents with low rectal cancer from the distress of anal amputation while ensuring oncological efficacy. However, due to the necessity of removing part or all of the internal sphincter during rectal resection and the extremely low anastomosis level, a subset of patients may experience low anterior resection syndrome (LARS) after surgery. LARS is characterized by symptoms such as anal incontinence, increased bowel frequency, urgency, incomplete evacuation, and obstructed defecation. Based on relevant literature and team practice, the authors provide an overview of the diagnosis and treat-ment progress of LARS following ISR.

In this paper,a case of a hyperdivergent and bimaxillary protrusion with individual teeth cross bite in the anterior region treated by invisible orthodontic appliances was reported.At the end of the treatment,the teeth were aligned,the face profile of the patient was im-proved and the overbite and overjet were normal.

Objective:To analyze and evaluate the expressions and clinical value of tuftelin (TUFT1) and Krüppel-like factor 5 (KLF5) in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) tissues.Method:KLF5 mRNA and TUFT1 mRNA transcriptional status in cancer and non-cancer groups were compared according to the Cancer Genome Atlas (TCGA) database. The differences and prognostic value between the groups were analyzed. Postoperative liver cancer and its paired pericancerous tissues, with the approval of the ethics committee, were collected to build tissue chips. The expression of KLF5 and TUFT1 and their intracellular localization were verified by immunohistochemistry. Tissue expression and clinicopathological characteristics were analyzed by immunoblotting. SPSS software was used to analyze the relationship between SPSS and patient prognosis.Results:The transcription level of TUFT1 or KLF5 mRNA was significantly higher in the HCC group than the non-cancer group ( P ?

Objective:To analyze the research hotspots and development directions of medical device information management,and to provide reference for the research of medical device information management.Methods:A total of 5434 articles related to information management in the field of medical devices were retrieved from the China National Knowledge Infrastructure(CNKI)database from January 1,2000 to December 31,2023.After screening,1618 valid articles were finally included in the study.Bibliometric methods were used to analyze the publication volume,keywords,journals,and author affiliations,and CiteSpace software was used to visualize the results.Results:The number of literature in the field of medical device information management showed a linear increase from 2000 to 2023,with an average of 70.34 publications per year.The keywords of"medical equipment,""medical consumables,""medical devices,""information systems,"and"management"have the highest centrality.The most representative keywords in cluster analysis are"medical equipment","medical consumables","quality control","management",and"Internet of Things".Conclusion:The research on medical device information management has gone through the initial stage,development stage,integration and integration stage,and the keyword"Internet of Things"has quickly become a research hotspot since its first appearance,and medical device information management has become the main development direction.The medical device management system has effectively improved the service quality and management level of medical institutions with the integration application of various information technologies and management tools and met the growing demand for statistical analysis.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the investigation of co-morbidity etiology and prognosis analysis of chronic diseases in the elderly population. Methods The data of 1 475 elderly patients who were seen and treated in Chengdu Fifth People's Hospital from January 2019 to December 2021 were screened to analyze their disease status, co-morbidity combinations and patterns, co-morbidity influencing factors, and prognosis. Results The top four prevalence rates among 1 475 elderly patients with chronic diseases were hypertension 555 (37.63%), gastric or gastrointestinal diseases 445 (30.17%), arthritis or rheumatism 427 (28.95%), and diabetes 329 (26.58%). 1034 co-morbidities were found in 1475 elderly patients with chronic diseases, with a co-morbidity rate of 70.10%. The binary disease combination accounted for 58.41% and the ternary disease combination accounted for 41.59%. Female, age >70 years, family history of chronic diseases, overweight/obesity, daily physical inactivity, history of alcohol/smoking, poor sleep quality, and poor dietary habits were the independent influencing factors for co-morbidity in elderly patients with chronic diseases (OR_female=2.413, ORage ≥ 70=1.670, OR_{history of alcohol consumption}family history of chronic diseases=2.846, OR_{history of alcohol consumption}overweight/obesity=2.570, ORdaily inactivity=1.802, OR_{history of alcohol consumption}=3.543, ORhistory of smoking=1.784, OR_{poor sleep quality}=2.128, OR_{unhealthy dietary habits}=2.085, all P<0.05). Compared with elderly patients with chronic diseases without co-morbidity, patients with co-morbidity had higher odds of exacerbation of the original disease/acute readmission and lower odds of new chronic disease (χ²_{primary exacerbation/emergency readmission}=10.726, χ²_{new chronic disease}=5.873 , all P<0.05). Conclusion Gender, age, chronic disease history, BMI, and lifestyle habits are important factors influencing co-morbidity in elderly patients with chronic diseases, and patients with co-morbidity have a relatively poor prognosis.

Objective To explore the correlation between the serum levels expression of microRNA(miR)-133a-3p,protein tyrosine phosphatase nonreceptor type 22(PTPN22)and the severity of psoriasis vulgaris.Methods A total of 86 patients with psoriasis vulgaris who were admitted to Cangzhou People's Hospital from January 2022 to June 2022 were collected as the observation group.They were separated into a progressive group(n=41)and a quiescent group(n=45)based on the area and severity of the skin lesions.Meantime,86 healthy individuals undergoing plastic surgery examinations were regarded as the control group.Real time fluorescent quantitative PCR(qRT-PCR)method was applied to detect the relative expression levels of miR-133a-3p and PTPN22 in serum.Target Scan Human website was applied to predict the targeting relationship between PTPN22 and miR-133a-3p.Spearman method was applied to analyze the correlation between the expression levels of miR-133a-3p and PTPN22 in serum of patients with psoriasis vulgaris,the psoriasis area and the psoriasis area and severity index score(PASI).Logistic regression was applied to analyze the influencing factors of severity in patients with psoriasis vulgaris.Results Compared with the control group,the serum miR-133a-3p(1.85±0.46 vs 1.05±0.21)expression level in the observation group was increased,while the PTPN22 mRNA(0.76±0.13 vs 1.02±0.18)expression level was reduced,and the difference were statistically significant(t=14.671,10.859,all P<0.05).Compared with the quiescent group,the serum miR-133a-3p(2.05±0.52 vs 1.67±0.41)expression level in the progressive group was increased,while the PTPN22 mRNA(0.66±0.11 vs 0.85±0.15)expression level was reduced and the differences were statistically significant(t=3.780,6.643,all P<0.05).Target Scan Human website predicted that there may be a targeting relationship between miR-133a-3p and PTPN22.Spearman analysis showed that there was a positive correlation between serum miR-133a-3p and PASI score in patients with psoriasis vulgaris(r=0.469,P<0.05),while serum TPN22 mRNA level was negatively correlated with PASI score(r=0.469,P<0.05).Serum miR-133a-3p[OR(95%CI)=2.884(1.261～6.595)]was an independent risk factor for the severity of psoriasis vulgaris,while PTPN22[OR(95%CI)=0.562(0.367～0.860)]was an independent protective factor(all P<0.05).Conclusion The expression level of miR-133a-3p in serum of patients with psoriasis vulgaris was increased,while the expression level of PTPN22 was reduced.The two were closely related to the PASI score and may to some extent reflect the severity of psoriasis patients.