Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective To investigate the characteristics and differences between two type 2 diabetic model mice,db/db and KK-Ay,as models of diabetic nephropathy(DN),and to verify them with irbesartan treatment.Methods A total of 102 db/db and 102 KK-Ay mice(12 weeks old)were screened based on the albumin-to-creatinine ratio(ACR)and 24-hour urinary total protein(UCFP),with 78 mice of each strain selected and divided into 6 groups.The db/db+irbesartan group and KK-Ay+irbesartan group were administered irbesartan(40 mg/kg),the db/db group and KK-Ay group received an equal volume of drinking water for experimental animals,and the db/db+test article A groups and KK-Ay+test article A groups were given different doses of test article A(only the result of mortality data in the test articles groups were presented in the study,while other result were not shown).Wild-type C57BL/6J(WTa/WTb group)served as the normal control and were given experimental animal drinking water.Daily clinical observations were made,body mass was measured weekly,and ACR and UCFP were monitored periodically.At the end of administration,the mice were dissected,and the brain,liver,lungs and kidneys were collected,and the organ coefficients(organ mass× 1000/body mass)were calculated.Blood was collected to measure serum total protein(TP),albumin(Alb),blood urea nitrogen(BUN),glucose(GLU),triglycerides(TG),and cholesterol(CHO).Kidney tissues were stained with HE,MASSON,and PAS to observe histopathological changes.Results Among the 78 KK-Ay mice,5 died over 8 weeks,while among the 78 db/db mice,21 died over 6 weeks.ACR increased with age in both the db/db and KK-Ay groups but decreased in the db/db+irbesartan and KK-Ay+irbesartan groups,though without statistical significance(P＞0.05).UCFP increased with age in the KK-Ay group but significantly decreased after irbesartan treatment(P＜0.05).Compared with the WT groups,the kidney coefficients in the db/db and KK-Ay groups showed no significant changes(P＞0.05),while the brain liver coefficients decreased significantly(P＜0.01)and the liver coefficients increased significantly(P＜0.01),but they did not change after irbesartan treatment(P＞0.05).Compared with the WT groups,GLU and TG levels were significantly increased in the db/db and KK-Ay groups(P＜0.01).Compared with the KK-Ay group,GLU and TG levels were significantly reduced in the KK-Ay+irbesartan group(P＜0.01).In the db/db and KK-Ay groups,kidney tissues showed thickening of the glomerular mesangial matrix and mesangial cell proliferation,which were alleviated after irbesartan treatment.Conclusions Both 12-week-old db/db and KK-Ay mice can serve as models for DN research.Compared with db/db mice,KK-Ay mice exhibited smaller individual differences in ACR,fewer animal deaths after urine collection,and significant improvements in GLU,TG and UCFP after irbesartan treatment.

Objective:To evaluate the efficacy and safety of upadacitinib in the real-world treatment of difficult-to-treat Crohn's disease (DTT-CD) .Methods:This multicenter, retrospective cohort study included patients diagnosed with DTT-CD according to the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) criteria, and treated at eight Chinese inflammatory bowel disease centers between January 2023 and March 2025. Clinical outcomes were assessed after 12 weeks of induction therapy with upadacitinib (45 mg qd), including clinical remission rate, clinical response rate, and incidence of adverse events.Results:Among 151 enrolled DTT-CD patients, the clinical remission rate was 47.0%, and the clinical response rate was 90.7% after 12 weeks of treatment. Adverse events occurred in 42 cases (27.8%) .Conclusion:Upadacitinib demonstrated favorable efficacy in inducing clinical remission in DTT-CD patients, with a good safety profile at the induction dose (45 mg qd) .

Objective:To evaluate the efficacy and safety of upadacitinib in the real-world treatment of difficult-to-treat Crohn's disease (DTT-CD) .Methods:This multicenter, retrospective cohort study included patients diagnosed with DTT-CD according to the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) criteria, and treated at eight Chinese inflammatory bowel disease centers between January 2023 and March 2025. Clinical outcomes were assessed after 12 weeks of induction therapy with upadacitinib (45 mg qd), including clinical remission rate, clinical response rate, and incidence of adverse events.Results:Among 151 enrolled DTT-CD patients, the clinical remission rate was 47.0%, and the clinical response rate was 90.7% after 12 weeks of treatment. Adverse events occurred in 42 cases (27.8%) .Conclusion:Upadacitinib demonstrated favorable efficacy in inducing clinical remission in DTT-CD patients, with a good safety profile at the induction dose (45 mg qd) .

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective To investigate the characteristics and differences between two type 2 diabetic model mice,db/db and KK-Ay,as models of diabetic nephropathy(DN),and to verify them with irbesartan treatment.Methods A total of 102 db/db and 102 KK-Ay mice(12 weeks old)were screened based on the albumin-to-creatinine ratio(ACR)and 24-hour urinary total protein(UCFP),with 78 mice of each strain selected and divided into 6 groups.The db/db+irbesartan group and KK-Ay+irbesartan group were administered irbesartan(40 mg/kg),the db/db group and KK-Ay group received an equal volume of drinking water for experimental animals,and the db/db+test article A groups and KK-Ay+test article A groups were given different doses of test article A(only the result of mortality data in the test articles groups were presented in the study,while other result were not shown).Wild-type C57BL/6J(WTa/WTb group)served as the normal control and were given experimental animal drinking water.Daily clinical observations were made,body mass was measured weekly,and ACR and UCFP were monitored periodically.At the end of administration,the mice were dissected,and the brain,liver,lungs and kidneys were collected,and the organ coefficients(organ mass× 1000/body mass)were calculated.Blood was collected to measure serum total protein(TP),albumin(Alb),blood urea nitrogen(BUN),glucose(GLU),triglycerides(TG),and cholesterol(CHO).Kidney tissues were stained with HE,MASSON,and PAS to observe histopathological changes.Results Among the 78 KK-Ay mice,5 died over 8 weeks,while among the 78 db/db mice,21 died over 6 weeks.ACR increased with age in both the db/db and KK-Ay groups but decreased in the db/db+irbesartan and KK-Ay+irbesartan groups,though without statistical significance(P＞0.05).UCFP increased with age in the KK-Ay group but significantly decreased after irbesartan treatment(P＜0.05).Compared with the WT groups,the kidney coefficients in the db/db and KK-Ay groups showed no significant changes(P＞0.05),while the brain liver coefficients decreased significantly(P＜0.01)and the liver coefficients increased significantly(P＜0.01),but they did not change after irbesartan treatment(P＞0.05).Compared with the WT groups,GLU and TG levels were significantly increased in the db/db and KK-Ay groups(P＜0.01).Compared with the KK-Ay group,GLU and TG levels were significantly reduced in the KK-Ay+irbesartan group(P＜0.01).In the db/db and KK-Ay groups,kidney tissues showed thickening of the glomerular mesangial matrix and mesangial cell proliferation,which were alleviated after irbesartan treatment.Conclusions Both 12-week-old db/db and KK-Ay mice can serve as models for DN research.Compared with db/db mice,KK-Ay mice exhibited smaller individual differences in ACR,fewer animal deaths after urine collection,and significant improvements in GLU,TG and UCFP after irbesartan treatment.

Objective To understand the current situation and influencing factors of kindergarten teach-ers'participation in training for preschool sex education in Luzhou city,and provide a basis for improving the sex education literacy of kindergarten teachers in the future.Methods A multi-stage stratified cluster sampling meth-od was adopted,and a questionnaire survey was conducted from December 2021 to January 2022 on the knowl-edge,attitude,and practice of preschool sex education among all the teachers in 24 kindergartens in Luzhou city.Results Among the 461 teachers,43.0％had participated in lectures/courses/training activities related to pre-school sex education;99.1％hoped to participate in lectures/courses/training activities related to preschool sex education;82.6％learned about child sexual knowledge through school education;75.5％expressed the hope to learn about child sexual knowledge through expert training.The results of multivariate Logistic regression showed that except private kindergartens as an inhibiting factor(OR=0.57,95％CI=0.37-0.87,P=0.008),high monthly income(OR=3.52,95％CI=1.13-9.30,P=0.011),more ways to know about sex education knowledge(OR=2.87,95％CI=1.76-4.70,P＜0.001),and social support(OR=1.58,95％CI=1.04-2.38,P=0.030)were promoting factors for teachers to participate in the training for preschool sex educa-tion.Conclusions The kindergarten teachers presented a participation rate but a high demand for the training for preschool sex education.They mainly obtain the sex education knowledge from school education.The nature of kindergarten,monthly income of teachers,social support situation,and ways of understanding sex education knowledge are the key factors influencing the teachers'participation in the training for preschool sex education.

【Objective】 To analyze the basic characteristics of whole blood donors from blood stations before and after the outbreak of COVID-19. 【Methods】 After excluding invalid data, data related to the basic characteristics of whole blood donors collected from 26 blood stations in China during 2018 to 2021 were statistically analyzed, including the trend of total whole blood donors, the number of repeated blood donors, the frequency of blood donation, the average age of donors and the recruitment of first-time blood donors. 【Results】 Affected by the epidemic, 8 out of 14 indicators were with large variations, accounting for 57%. The overall growth rate of total whole blood donors during the epidemic was higher than before the epidemic (P<0.05).The number of repeated blood donors has shown an increased trend, with a higher number during the epidemic than before (P<0.05). The frequency of blood donation was lower during the epidemic than before(P<0.05).Average ages of blood donors and female blood donors fluctuated widely during the epidemic, both higher than those before the epidemic(P<0.05).The donation rate of first-time blood donors <25 years old and ≥25 years old varied widely and irregularly during the epidemic (both P<0.05). The percentage of first-time blood donors fluctuated irregularly during the epidemic, with overall percentage lower than that before the epidemic(P<0.05). 【Conclusion】 Whole blood donors from 26 blood stations increased after the outbreak of COVID-19, and some indicators in certain areas showed significant fluctuations during the epidemic.

Objective To establish a UPLC-MS/MS method for the determination of dexmedetomidine in human plasma and investigate the effect of obstructive jaundice on pharmacokinetics of dexmedetomidine in vivo. Methods Samples were obtained by liquid-liquid extraction. Agilent Eclipse Plus C₁₈ column was used for chromatograph with methanol and 0.1% formic acid-water solution as mobile phase. Flow rate was 0.2 ml/min. The column temperature was 35 ℃, and the MS detection was selected in MRM mode. Results The calibration curves of dexmedetomidine showed good linearity in the ranges of 0.01−10.00 ng/ml. The results of intra and inter-day precisions were both within 15%. The recovery rate was 85.5%−93.1%. Matrix effect was 91.2%−95.6%. Samples remained stable during analysis. Compared with the control group, c_max、AUC_(0−t)、AUC_(0−∞) and V_z of dexmedetomidine in the patients with obstructive jaundice were increased by 63.4%, 78.9, 66.4%, 82.5%, respectively (P<0.01). CLz was decreased by 42.1%. Conclusion This method is accurate, sensitive and reproducible. It is suitable for dexmedetomidine assay in human plasma. The elimination rate of dexmedetomidine is slower in obstructive jaundice.

Objective:To investigate the changes and clinical significance of body mass index (BMI), blood lipid and fat soluble vitamin levels in patients with different types of severe preeclampsia.Methods:Sixty-eight pregnant women with severe preeclampsia who received antenatal examination in Lishui Maternal and Child Health Care Hospital, China from February 2017 to February 2019 were included in the study group. According to the onset time, the pregnant women were divided into an early onset group (≤ 34 weeks of gestation, n = 38) and a late onset group (> 34 weeks of gestation, n = 30). An additional 50 healthy pregnant women who concurrently received antenatal examination in the same hospital were included in the control group. Serum levels of triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), vitamin A (VA), vitamin E (VE) and vitamin D 3 (VD 3) were determined in all pregnant women. Logistic regression was used to analyze severe preeclampsia-related influential factors. Results:There were no significant differences in age, number of births and number of pregnancies among the three groups (all P > 0.05). BMI and serum levels of VA, VE, TC, TG, and LDL-C were (22.99 ± 4.39) kg/m 2, (0.48 ± 0.08) ng/mL, (11.91 ± 1.74) ng/mL, (4.93 ± 0.34) mmol/L, (1.57 ± 0.26) mmol/L, (2.68 ± 0.27) mmol/L, respectively, which were significantly higher than those in the control group [(20.68 ± 3.68) kg/m 2, (0.40 ± 0.07) ng/mL, (10.32 ± 2.56) ng/mL, (4.12 ± 0.67) mmol/L, (1.25 ± 0.32) mmol/L, (2.15 ± 0.32) mmol/L, t = 3.725, 6.698, 4.352, 8.731, 6.282, 10.512, all P < 0.05]. Serum levels of HDL-C and VD 3 in the study group were (1.51± 0.32) mmol/L and (16.16 ± 2.37) ng/mL, respectively, which were significantly lower than those in the control group [(1.88 ± 0.57) mmol/L, (17.86 ± 2.39) ng/mL, t = - 6.959, - 4.520, both P < 0.05]. BMI and serum levels of TC, TG, LDL-C, VA and VE in the early onset group were (23.13 ± 4.13) kg/m 2, (5.05 ± 0.34) mmol/L, (1.62 ± 0.27) mmol/L, (2.95 ± 0.32) mmol/L, (0.52 ± 0.06) ng/mL, (12.16 ± 1.80) ng/mL, respectively, which were significantly higher than those in the control group ( t = 6.507, 17.462, 11.217, 16.593, 9.075 and 4.142, all P < 0.05). Serum levels of HDL-C and VD 3 in the early onset group were (1.43 ± 0.28) mmol/L and (15.76 ± 2.42) ng/mL, respectively, which were significantly lower than those in the control group ( t = 14.635, 5.871, both P < 0.05). BMI and serum levels of TC, TG and VE in the late onset group were (22.70 ± 4.32) kg/m 2, (4.67±0.32) mmol/L, (1.49 ± 0.25) mmol/L and (11.45 ± 1.61) ng/mL, respectively, which were significantly higher than those in the control group ( t = 5.821, 12.857, 8.059, 3.482, all P < 0.05). Serum level of VD3 in the late onset group was (16.72 ± 2.31) ng/mL, which was significantly lower than that in the control group ( t = 4.319, P = 0.01). There were no significant differences in serum levels of LDL-C, HDL-C and VA between late onset group and control group (all P > 0.05). There were no significant differences in BMI, and serum levels of TC, TG, HDL-C, LDL-C, VA, VD 3 and VE between early onset and late onset groups (all P > 0.05). Logistic regression analysis results revealed that BMI and serum levels of TG, TC, HDL-C, LDL-C, VA, VD 3 and VE are independent influential actors of early onset severe preeclampsia ( P = 0.000, 0.008, 0.032, 0.043, 0.032, 0.002, 0.041, 0.009). BMI and serum levels of TG, TC, VD 3 and VE are independent influential actors of late onset severe preeclampsia ( P = 0.002, 0.016, 0.013, 0.031, 0.042). BMI, blood lipid and fat soluble vitamin in combination are of high value for the prediction of early onset severe preeclampsia (sensitivity 87.81% and specificity 76.67%), but they are not of high value for the prediction of late onset severe preeclampsia (sensitivity 52.51% and specificity 55.10%). Conclusion:BMI, serum lipid and fat soluble vitamin in combination are of high value in the prediction of early-onset severe preeclampsia.