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 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 survey the child health service capacity of community health service institutions in Shenzhen city.Methods:This was a cross-sectional study. An online survey was conducted among 559 community health service centers, stations and clinics in Shenzhen from January 23, 2024 to February 3, 2024. The questionnaire contents included the development of child health management, vaccination, diagnosis and treatment of common diseases in children, management of children′s chronic diseases, appropriate technology, availability of children′s special drug dosage forms, provision of special Chinese patent medicine and appropriate technology of traditional Chinese medicine for children, referral and remote consultation in 2019 and 2023. The reasons of unavailable service items were asked in the questionnaire and the questionnaire also contained an open-ended question about the suggestions for improving the capacity of child health services.Results:A total of 559 valid questionnaires were collected, accounting for 64.48% (559/867) of the community health service centers, stations and health clinics in Shenzhen in 2023. Compared to 2019, there was a significant increase in the rate of pediatric health services provided in 2023, including the diagnosis and treatment of common diseases in children under 6 years (96.06%, 537 institutions), nebulized inhalation therapy (96.60%, 540 institutions), influenza and other respiratory pathogen detection (90.70%, 507 institutions), rotavirus and other intestinal pathogen detection (34.53%, 193 institutions), allergen detection (81.75%, 457 institutions), blood oxygen saturation monitoring (84.44%, 472 institutions), pediatric-specific formulations of Western medicine (90.52%, 506 institutions), pediatric-specific formulations of traditional Chinese medicine (89.27%, 499 institutions), appropriate Chinese medicine techniques (88.19%, 493 institutions), relatively fixed referral hospitals (95.17%, 532 institutions), and remote consultation service (19.14%, 107 institutions); and the differences were statistically significant ( P<0.01). The reasons for unavailable service items were lack of space and personnel for the basic public health services, lack of space, personnel and a deficiency in knowledge and technical capabilities for diagnostic tests, and lack of equipment and personnel for remote consultation service. Suggestions made by 394 respondent institutions (70.48%) for further improvement included: conducting and strengthening various training (44.42%, 175/394), consultation and teaching by expert visiting (18.53%, 73/394), increasing the space and equipment (9.39%, 37/394), and further study at higher-level units (98.88%, 35/394). Conclusions:The child health services have been greatly improved in community health service institutions in Shenzhen, but there are still rooms for further improvement such as the ability of child health management, vaccination, chronic disease managements and provision of remote consultation.

Objective:To explore the value of synthetic MRI and dynamic contrast-enhanced MRI (DCE-MRI) in differentiating benign and malignant breast lesions.Methods:Totally 116 patients (female, aged 22-80 years) with suspicious breast lesions found by clinical examination in General Hospital of Ningxia Medical University from September 2020 to March 2021 were retrospectively analyzed. All patients received synthetic MRI and DCE-MRI scans, and the quantitative parameters of synthetic MRI [T 1, T 2, proton density (PD) value before enhancement of breast lesions (T 1pre, T 2pre, PD pre) and T 1, T 2, PD value after enhancement of breast lesions (T 1Gd, T 2Gd, PD Gd)] were measured. The difference before and after enhancement (?T 1, ?T 2, ?PD) and the ratio before and after enhancement(T 1ratio, T 2ratio, PD ratio) were calculated. All lesions were confirmed by biopsy or surgery. Independent sample t test was used to compare the differences of parameters between benign and malignant lesions, and parameters with statistically significant differences were analyzed by multivariate logistic regression to screen out independent predictors for the diagnosis of breast malignant lesions. The efficacy of quantitative parameters alone and in combination with DCE-MRI, was evaluated by the receiver operating characteristic (ROC) curve. Results:Of 116 patients, 27 patients were benign and 89 patients were malignant. T 2pre, PD pre, T 2Gd, PD Gd, ?T 2, T 1ratio and T 2ratio values of malignant patients were lower than those of benign lesions ( P<0.05). Multivariate logistic regression analysis showed that T 2pre (OR=0.961,95%CI 0.926-0.993, P=0.022)and PD pre(OR=0.945, 95%CI 0.908-0.979, P=0.003) were independent predictors of breast malignant lesions. The area under ROC curve (AUC) of T 2pre+PD pre in differentiating benign and malignant breast lesions was 0.77, and the accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 0.84, 0.87, 0.68, 0.92 and 0.56, respectively. The AUC of T 2pre+PD pre combined with DCE-MRI in differentiating benign and malignant breast lesions was 0.95, indicating the best diagnostic efficiency, and higher than that of DCE-MRI alone (0.92)( Z=2.20, P<0.05). Conclusions:T 2pre and PD pre values of synthetic MRI can be used as reference parameters for differentiating benign and malignant breast lesions. Synthetic MRI combined with DCE-MRI can effectively improve the diagnostic efficiency of breast malignant lesions.

Objective: To observe the effects of ginger-partitioned moxibustion at Shenque (CV8) and Guanyuan (CV4) on the expression levels of endocrine-related molecules and their receptors in rats with primary dysmenorrhea (PD) due to cold-dampness stagnation, thus to explore their analgesic mechanisms. Methods: Thirty-two female Wistar rats were divided into a normal group, a model group, a ginger-partitioned moxibustion group, and a Western medicine group according to the random number table method, with 8 rats in each group. Except for rats in the normal group, all other rats were treated with oxytocin combined with ice-water bath to establish the rat models of PD due to cold-dampness stagnation. After successful modeling, rats in the normal group and the model group did not receive treatment; rats in the ginger-partitioned moxibustion group received treatments with ginger-partitioned moxibustion at Shenque (CV8) and Guanyuan (CV4); rats in the Western medicine group received ibuprofen by intragastric administration. The writhing response of rats was compared among groups, and the serum levels of prostaglandin F2α (PGF2α), estrogen (estradiol, E2), progesterone (P), and the mRNA expression of PGF2α and E2 receptors in the uterine tissues were detected. Results: No writhing behavior was observed in the normal group; compared with the normal group, the serum PGF2α and E2 levels in the model group were increased (P<0.01), while the P level was decreased (P<0.01), and the mRNA expression levels of the uterine PGF2α and E2 receptors were increased (P<0.01, P<0.05). Compared with the model group, the writhing behavior latency was prolonged, and the writhing response score was decreased in the ginger-partitioned moxibustion group and the Western medicine group (P<0.01); the serum PGF2α and E2 levels in the ginger-partitioned moxibustion group and the Western medicine group were decreased, while the P level was increased (P<0.05 or P<0.01); the mRNA expression levels of the uterine PGF2α and E2 receptors in the ginger-partitioned moxibustion group and the Western medicine group were decreased (P<0.05). Compared with the Western medicine group, the ginger-partitioned moxibustion group showed a prolonged writhing behavior latency, reduced writhing response score (P<0.05), and decreased serum E2 level (P<0.05), while no statistical differences in the serum PGF2α and P levels, or the mRNA expression levels of uterine PGF2α and E2 receptors (P>0.05).Conclusion: The analgesic effect of ginger-partitioned moxibustion on PD due to cold-dampness stagnation may be related to regulating the mRNA expression levels of PGF2α and E2 receptors in the uterine tissues.

Adult ; Antibodies, Viral/isolation & purification* ; COVID-19/virology* ; Feces/chemistry* ; Female ; Humans ; Intestines/virology* ; Male ; RNA, Ribosomal, 16S/genetics* ; RNA, Viral/isolation & purification* ; SARS-CoV-2/pathogenicity*

Objective To investigate ablation characteristics of PVC/VT originating from left ventricle anterior papillary muscles.Methods This study included 10 patients of PVC/VT originating from left ventricle anterior papillary muscles from January 2015 to June 2016 in Beijing Anzhen Hospital.Electrophysiological mapping and radiofrequency ablation were completed using three-dimensional anatomical mapping system combined with three-dimensional intracardiac ultrasound technology.ECG and abaltion target diagram characteristics as well as the special anatomy were explored.Results All the 10 patients were successfully ablated and followed up for 12 months.One patient had recurrence within 12 months and no complications were recorded.The target sites localized at the tip (n =1),middle portion(n =4)or the base (n =5) of the LV-APM.Among 7 patients,the target sites were located at the anterior septal papillary muscle and in 3 patients were located in the free papillary muscle.9 patients were successfully ablated via anterograde trans-septal catheterization after the failure of retrograde approach.Premature QRS wave time were 152.80 ± 11.72 ms and 6 patients presented sharp potential at the targets during PVC/VT.Conclusions PVC/VT originating from left ventricle anterior papillary muscles have similar ECG and diagram characteristics that is different from which originating from left anterior fascicle.It is recommended to get the target via transseptalpuncure approach.Ablation target could be clearly positioned by three-dimensional intracardiac ultrasound technology.

Objective To develop a machine simultaneously integrating mechanized environmental cleaning and automatic mollusciciding and to evaluate its effectiveness of field application,so as to provide a novel Oncomelania hupensis snail control technique in the large?scale marshlands. Methods The machine simultaneously integrating mechanized environmental clean?ing and automatic mollusciciding,which was suitable for use in complex marshland areas,was developed according to the mech?anization and automation principles,and was used for O. hupensis snail control in the marshland. The effect of the machine on environmental cleaning and plough was evaluated,and the distribution of living snails was observed at various soil layers follow? ing plough. The snail control effects of plough alone and plough followed by mollusciciding were compared. Results The ma?chine could simultaneously complete the procedures of getting vegetation down and cut vegetation into pieces,plough and snail control by spraying niclosamide. After plough,the constituent ratios of living snails were 36.31% ,25.60% ,22.62% and 15.48% in the soil layers at depths of 0-5,6-10,11-15 cm and 16-20 cm respectively,and 61.91% living snails were found in the 0-10 cm soil layers. Seven and fifteen days after the experiment,the mortality rates of snails were 9.38% and 8.29% in the plough alone group,and 63.04% and 80.70% in the plough + mollusciciding group respectively(c27 d = 42.74,c215 d =155.56,both P values < 0.01). Thirty days after the experiment,the densities of snails were 3.02 snails/0.1 m2 and 0.53 snails/0.1 m2 in the soil surface of the plough alone group and the plough + mollusciciding group,which decreased by 64.92% and 93.60% ,respectively,and the decrease rate of snail density was approximately 30% higher in the plough + mollusciciding group than that in the plough alone group. Conclusions The machine simultaneously integrating mechanized environmental cleaning and automatic mollusciciding achieves the integration of mechanical environmental cleaning and automatic niclosamide spraying in the complex marshland areas,which provides a novel technique of field snail control in the large?scale setting in Chi?na.

Objective To evaluate the potential risk of schistosomiasis transmission in the area along the Yangtze River in Yangzhou City,so as to provide evidences for establishing a post?transmission surveillance system for schistosomiasis in marsh?land regions. Methods The water infectivity,floating boatmen and fishermen infection,reservoir host infection and wild feces contamination were investigated in five districts/counties along the Yangtze River in Yangzhou City,including Guangling,Hanji?ang,Jiangdu,Yizheng and Development Zone,and the transmission factors and risky characteristics were assessed after inter?ruption of schistosomiasis transmission in marshland regions. Results A total of 15 key water regions were identified in the area along the Yangtze River in Yangzhou City in 2015. A total of 1 500 sentinel mice were placed,after breeding,their overall sur?vival rate was 99.33%;1 490 were dissected,with no schistosome infection. Of the 5 576 floating boatmen and fishermen exam?ined,no schistosome infection was observed,and among the 3 566 domestic animals(including 171 cattle,1 895 sheep and 1 500 pigs),no infections were detected. During the period between January and March,2016,there were 3 200 mouse traps placed on 8 marshlands,and 62 wild mice were captured from 6 marshlands,with a capture rate of 1.94%,and no schistosome?infected wild mice were seen. In addition,there were 35 pieces of fresh wild feces captured from 7 marshlands,including 11 pieces of bovine feces(31.43%),17 pieces of sheep feces(48.57%),2 pieces of dog feces(5.71%)and 5 pieces of other feces (14.29%),and no infections were detected. Conclusions There is a low risk of schistosomiasis transmission in the area along the Yangtze River in Yangzhou City. However,the contamination of feces from bovine and sheep that are freely pastured on marshlands is a big threat to schistosomiasis control.

OBJECTIVE: To investigate the expression of breast cancer metastasis suppressor 1 (BRMS1) gene protein and the expression of BRMS1 gene promotor area methylation in supraglottic cancer and to evaluate its clinical significance. METHOD: The expression of BRMS1 protein and BRMS1 gene promotor area methylation were examined by using Western blotting method and methylation-specific polymerase chain reaction(MSP) method in 70 cases of supraglottic cancer tissues and 60 cases of their surrounding laryngeal normal mucosa tissues (LNT) and 44 cases of cervical lymph node metastasis of supraglottic cancer. RESULT: Western blot results indicate that BRMS1 protein expression is declined expression level in supraglottic cancer tissue than the expression of BRMS1 protein in LNT of supraglottic cancer. Compared with para carcinoma normal laryngeal mucous tissue, BRMS1 gene protein in supraglottic cancer tissue primary lesion decreased obviously, and it is decreased more obviously in cervical lymph node metastasis lesion, the discrepancy is notable (P < 0.05). MSP results indicate BRMS1 gene promotor methylation is coordinated with its down-expression in supraglottic cancer tissue. BRMS1 promotor area methylation analysis reveal that there were 34 patients with methylation in 70 patients' supraglottic cancer tumor primary lesion, hold 48.6% (34/70); 32 patients have methylation in 44 patients' cervical metastasis lymph node tissue, hold 72.7% (32/44); however, there is no methylation in 60 para carcinoma tissue (r(s) = 0.66, P < 0.05). CONCLUSION The expression of BRMS1 protein in supraglottic cancer is significantly decreased. It had correlation with clinical stage and pathologic differentiation and cervical lymph node metastasis of supraglottic cancer. BRMS1 gene promotor methylation is related with down-expression of BRMS1 gene protein of supraglottic cancer. Maybe BRMS1 gene promotor methylation is one of the reasons of its down-expression.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; metabolism ; pathology ; DNA Methylation ; Female ; Glottis ; Head and Neck Neoplasms ; metabolism ; pathology ; Humans ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Proteins ; metabolism ; Neoplasm Staging ; Promoter Regions, Genetic ; RNA, Messenger ; genetics ; Repressor Proteins ; Squamous Cell Carcinoma of Head and Neck