Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2023.Methods Clinical isolates collected from 73 hospitals across China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2023 Clinical & Laboratory Standards Institute (CLSI) breakpoints.Results A total of 445199 clinical isolates were collected in 2023,of which 29.0％ were gram-positive and 71.0％ 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) (MRSA,MRSE and MRCNS) was 29.6％,81.9％ and 78.5％,respectively.Methicillin-resistant strains showed significantly higher resistance rates to most antimicrobial agents than methicillin-susceptible strains (MSSA,MSSE and MSCNS).Overall,92.9％ of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 91.4％ of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis had 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 93.1％ in the isolates from children and and 95.9％ in the isolates from adults.The resistance rate to carbapenems was lower than 15.0％ for most Enterobacterales species except for Klebsiella,22.5％ and 23.6％ of which were resistant to imipenem and meropenem,respectively .Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.6％ to 10.0％.The resistance rate to imipenem and meropenem was 21.9％ and 17.4％ for Pseudomonas aeruginosa,respectively,and 67.5％ and 68.1％ for Acinetobacter baumannii,respectively.Conclusions Increasing resistance to the commonly used antimicrobial agents is still observed in clinical bacterial isolates.However,the prevalence of important crabapenem-resistant organisms such as crabapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a slightly decreasing trend.This finding suggests that strengthening bacterial resistance surveillance and multidisciplinary linkage are important for preventing the occurrence and development of bacterial resistance.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2023.Methods Clinical isolates collected from 73 hospitals across China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2023 Clinical & Laboratory Standards Institute (CLSI) breakpoints.Results A total of 445199 clinical isolates were collected in 2023,of which 29.0％ were gram-positive and 71.0％ 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) (MRSA,MRSE and MRCNS) was 29.6％,81.9％ and 78.5％,respectively.Methicillin-resistant strains showed significantly higher resistance rates to most antimicrobial agents than methicillin-susceptible strains (MSSA,MSSE and MSCNS).Overall,92.9％ of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 91.4％ of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis had 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 93.1％ in the isolates from children and and 95.9％ in the isolates from adults.The resistance rate to carbapenems was lower than 15.0％ for most Enterobacterales species except for Klebsiella,22.5％ and 23.6％ of which were resistant to imipenem and meropenem,respectively .Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.6％ to 10.0％.The resistance rate to imipenem and meropenem was 21.9％ and 17.4％ for Pseudomonas aeruginosa,respectively,and 67.5％ and 68.1％ for Acinetobacter baumannii,respectively.Conclusions Increasing resistance to the commonly used antimicrobial agents is still observed in clinical bacterial isolates.However,the prevalence of important crabapenem-resistant organisms such as crabapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a slightly decreasing trend.This finding suggests that strengthening bacterial resistance surveillance and multidisciplinary linkage are important for preventing the occurrence and development of bacterial resistance.

Objective:To review the clinical and pathological features, pathogenesis, and differential diagnosis of leiomyomatosis peritonealis disseminata (LPD) during pregnancy.Methods:We report the diagnosis and treatment of LPD in a pregnant woman admitted to Jiaozhou Central Hospital of Qingdao. We retrieved relevant literature from China and abroad to review the clinical characteristics and outcomes.Results:(1) Case report: The 33-year-old pregnant woman who had had previous cesarean sections was admitted at 37 +2 weeks gestation due to premature rupture of membranes 30 minutes before arriving at the hospital with a pelvic mass which was first diagnosed seven months earlier, in the first trimester. A lower segment cesarean section was performed, and the pelvic mass was removed on admission. No relapse was reported during the postoperative follow-up for 26 months. (2) Literature review: thirteen papers involving 15 cases, including the present case, were retrieved. The age at onset was 32 years old (19-47 years old); five of them had a history of myomectomy. Twelve cases had no significant symptoms, and the diagnosis was made at delivery or postpartum; the other three had noticeable features, mainly with abdominal pain. Six had obstetrical complications, including hypertensive disorders of pregnancy, premature rupture of membrane, abnormal fetal position, and oligohydramnios. Two cases had a history of assisted reproductive technology. Eleven cases delivered after 32 gestational weeks, three before 28 weeks, one aborted at ten gestational weeks due to severe complications. Twelve had cesarean section and myomectomy and the uterus and appendages were preserved. Three cases had a cesarean hysterectomy and two of them also had bilateral salpingo-oophorectomy. The pathological manifestations of seven cases were extensive and massively distributed small fibroids, similar to malignant tumor infiltration, with the diameter of 0.5 to 1.0 cm; five cases had multiple large fibroids, accompanied by scattered small fibroids. Conclusion:LPD during pregnancy is rare, and usually benign, with no obvious clinical symptoms. LPD is more likely to be misdiagnosed as a malignant tumor before the operation, and the diagnosis is usually confirmed by postoperative histopathology. A common surgical strategy is a cesarean section combined with pelvic mass resection.

Objective To evaluate the efficacy of mirror therapy for stroke patients with hemiplegia.Methods Eighty stroke patients with hemiplegia were randomly divided into study group and control group with 40 cases in each group.Conventional rehabilitation training was given to patients in both groups;patients in study group were given additional mirror therapy for 24 weeks.The Fugl-Meyer Assessment (FMA) scale was used to assess the motor function,Functional Independence Measurement (FIM) scale to assess the activity of daily living,Modified Barthel Index to assess the ability of daily living,Brunnstrom Stage Scale to evaluate the states of the upper extremities,and the modified Ashworth Scale to evaluate muscle spasticity before and after 24-week treatment.Results Mter 24 weeks of treatment,there were significant differences in FMA score [(44.08 + 2.44) vs.(40.53 +2.11),t =7.07,P＜0.05,FIM score [(71.08 + 5.37) vs.(64.18 + 4.47),t =7.20,P ＜ 0.05],modified Barthel index score [(59.75+7.84) vs.(54.25 +8.88),t =3.03,P＜0.05 and Brunnstrom stage (Z=-3.000,P＜ 0.05) between the study group and the control group.However,there was no significant difference in modified Ashworth score between the two groups of patients (Z =-1.732,P ＞ 0.05).Conclusion Mirror therapy can improve upper limb and hand function of the stroke patients with hemiplegia and enhance their ability of daily life activities;however,it has no significant effect to improve the limb spasm.

Rhodiola capsules show the resistant effects on ischemia, anoxia, radiation, fatigue and virus and so on, and can im-prove the body immune function to relief the plateau symptoms such as fatigue and cerebral hypoxia. The influence mechanism of rhodi-ola capsules in the effect of anti-high altitude pulmonary edema was summarized in the paper.

Objective:To observe the effect of Jianpi Xiaozhang tablets on the bile secretion in rats. Methods: Totally 60 rats were divided into 6 groups randomly. Jianpi Xiaozhang tablet suspension(high, moderate, low dosages), Shudantong suspension, Qinggan Lidan capsule suspension and 0. 5% carboxymethyl cellulose with the same volume was respectively given with intragastric ga-vage once daily for continuous 5 days. The bile was collected to detect total bile acids ( TBA) , total cholesterol and total bilirubin. Re-sults:Jianpi Xiaozhang tablets could notably increase TBA and total bilirubin in the bile (P<0. 01), and decrease the cholesterol content significantly (P<0. 01). Conclusion:Jianpi Xiaozhang tablets can promote the bile secretion.

Objective To study clinical efficacy of porcine-derived small intestinal submucosa (Surgisis) in treatment of pelvic organ prolapse (POP).Methods From Mar.2012 to Mar.2013,15 patients with POP at more than Ⅲ of POP quantitation (POP-Q) staging system undergoing pelvic reconstructive surgery with Surgisis in Peking University People's Hospital.The mean age was 59 years old (39-82).The variable site of POP-Q staging systemn was compared between preoperative and postoperative status among those patients.Quality of life questionnaire of pelvic floor impact questionnaire (PFIQ-7),pelvic floor distress inventory short form (PFDI-20) and PISQ-31 were studied to evaluate subjective satisfaction,recurrence and the quality of life's improvement.Results All patients were followed up at mean of 9.9 months (3-15 months),the mean time of surgery was 96 mins (65-120 mins),the mean blood loss was 159 ml (50-500 ml).No infection and erosion was observed on those patients.The rate of subjective satisfaction was 14/15,the recurrence rate of prolapse was 2/15.Scoring system of PFDI-20 was from 87 (56-124) at operative status to 30 (22-48) at postoperative status.PFIQ-20 was from 129 (85-158) at preoperative status to 24 (18-48) at postoperative status.PISQ-31 was from 48 (32-55) at preoperative status to 79 (66-89) at postoperative status,which all reached statistical difference (all P ＜0.05).Total 9 patients obtained satisfactory sexual life.Conclusions The short-term clinical effect of pelvic reconstructive surgery with Surgisis was satisfied,quality of life and sexual life was improved,and less complication were observed.However,long-term clinical effect on patients should be warranted to follow up.

Objective To understand AIDS related knowledge,and to prevent and national control strategy among leaders from grass roots, and provide evidences for improving strategic support for HIV/AIDS prevention and control. Methods A total of 575 leaders from grass roots of Taishan district were chosen with cluster sampling. Health education methods included: giving special subject lecture about AIDS and handing out the beoklets,a questionnaire were conducted after Health education. Results A total of 401 leaders were investigated. The overall rate of correct answer about AIDS related knowledge was 86.30%, 83.79% of them know the national HIV/AIDS prevention and controlling policies "Four free and one care". Conclusion There are high level about AIDS related knowledge and the national HIV/AIDS prevention and controlling policies among leaders from grass roots of Taishan district after health education. AIDS health education needs to be strengthened so that prevention and control strategy could be implemented in an active manner.

BACKGROUND:Both in vivo and vitro microenvironment can influence the proliferation and differentiation of neural stem cells (NSCs). In addition, cell culture solution plays variable roles in cell proliferation and differentiation.OBJECTIVE:To develop a convenient and rapid method to promote NSC primary culture by modifying traditional serum-free medium. DESIGN, TIME AND SETTING:Randomized controlled cell trial was performed at Institute of Brain Science, Qingdao University Medical School from November 2005 to September 2006.MATERIALS:Ten Wistar rat of gestation for 12-16 days; cell suspension fron brain tissue of embryonic rat. METHODS:Cell suspension were seeded into four 50-mL culture flasks with cell density of 1×106 mL-1, and divided into 2 groups with 2 flasks in each group. The control cells (flasks A and B) were cultured in serum-free medium containing DMEM/F12, B27 (2%), basic fibroblast growth factor (20 μg/L), and epidermal growth factor (20μg/L), and the experimental cells (flasks C and D) were firstly cultured with DMEM/F12 containing fetal bovine serum (FBS, 5%), following by the same serum-free medium 2 to 3 days later. MAIN OUTCOME MEASURES:The proliferation of NSCs was observed by inverted microscopy and immunocytochemistry.RESULTS:①Most of the cells in two culture conditions expressed nestin, the specific marker of NSCs, and were immunocytochemically positive. ②Neural stem cells cultured with FBS formed neurospheres 3-4 days earlier than those without FBS. ③There were no significant differences in cell number, but the neurospheres under the experimental condition were larger than those in control group. Some of the cells were neurone specific enolase-positive after serum-conditioned induction, and some were glial fibrillary acidic protein-positive, indicating NSCs had differentiated into neuron-like cells and neurogliocytes.CONCLUSION:FBS-conditioned pre-culture can accelerate the proliferation of neural stem cells.