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 investigate the correlation between ITPKB mutation's variant allele frequency (VAF) and prognosis of diffuse large B-cell lymphoma (DLBCL). Methods This study included 155 patients with DLBCL initially diagnosed in the People's Hospital of Xinjiang Uygur Autonomous Region from June 2014 to December 2020. Paraffin-embedded tumor tissue specimens were obtained, and tumor tissue DNA was extracted. A total of 475 hotspot genes including ITPKB were detected by the next generation sequencing to analyze the relationship of the VAF of high-frequency mutant gene with progression-free survival (PFS) and overall survival (OS). Results The mutation frequency of ITPKB was 18.71%. The PFS was significantly shorter in the patients with ITPKB mutations than in those without mutations (37 months vs. 108 months; HR=1.643, 95%CI: 0.920-2.934, P=0.093). The R-language based web tool was used to find the best VAF cutoff to differentiate prognosis. The patients were divided into two groups (VAF High vs. VAF Low+Wt) according to their VAF values. The optimal VAF threshold for ITPKB was 27.48% (HR=3.480, 95%CI: 1.70-7.13, P=0.00027). Multivariate Cox analysis was conducted using clinical indicators such as age, gender, COO classification, IPI, and LDH, and the results showed that PFS was associated with high ITPKB VAF (≥28%) (HR=3.592, 95%CI: 1.738-7.425, P < 0.001) which was an independent adverse predictor of PFS. Conclusion The high load of ITPKB mutation is an independent risk factor for the PFS of patients with DLBCL, and the VAF of ITPKB mutation has a prognostic predictive value for patients with DLBCL.

Objective:To integrate the stigma experience of diabetes patients in the process of life, treatment and self-management, and understand their real feelings, so as to implement targeted interventions for diabetes patients.Methods:Qualitative research on stigma experience of diabetes patients was retrieved in PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI) , VIP, WanFang Data, and China Biomedical Literature Database. The search period was from the establishment of the database to June 2022. The method of aggregative integration was used to organize and analyze the included literature.Results:A total of 6 studies were included. A total of 37 results were extracted, forming 7 new categories, which were integrated into three integrated results (negative experience brought by stigma, peer support promoted positive coping with stigma, comparison of stigma and experience of patients with type 1 and 2 diabetes) .Conclusions:There are many forms of stigma in diabetes patients. It is necessary to pay attention to the different experiences of patients' stigma, take effective individualized interventions to reduce their stigma, enhance their self-management ability, and improve the quality of life.

Objective:To explore the early diagnostic value of serum procalcitonin(PCT),C-reactive protein (CRP) and endotoxin in patients with sepsis caused by bacterial bloodstream infection.Methods:Retrospectively analyzed 123 cases of patients diagnosed with sepsis induced by bacterial bloodstream infection in our hospital from May 2010 to May 2015,detected their serum PCT,CRP and endotoxin levels,and analyzed the evaluation value of these three indexes for sepsis induced by bacterial bloodstream infection by receiver-operating characteristic curve (ROC).Results:Blood sample culture results showed that 123 cases of bacterial bloodstream infections caused by sepsis patients in the presence of infection of G+bacteria were 35 cases,G-bacteria infection of 88 cases;The levels of three index in the G+bacteria group were significantly lower than that in the G-bacteria group (P＜0.05);The serum PCT,CRP and endotoxin levels was positive correlated with each other among G+bacteria group,G-bacteria group and all bacteria group;ROC curves showed that the cutoff value of serum PCT,CRP and endotoxin for diagnosis of patients with sepsis induced by G+bacteria bloodstream infection were 1.58 μg/L,95.25 mg/L and 16.71ng/L,and their sensitivity and specificity were (65.92％,88.37％),(67.39％,84.38％) and (56.34％,78.93％) respectively;and the cutoff value for diagnosis of patients with sepsis induced by G-bacteria bloodstream infection were 2.45 μg/L,79.45 mg/L and 15.54 ng/L,their sensitivity and specificity were (78.73％,97.13％),(68.89％,92.38％) and (65.39％,95.33％)respectively.Conclusion:Detecting the serum PCT,CRP and endotoxin levels is helpful to identify patients with sepsis induced by G+ or G-bacteria bloodstream infection,with high sensitivity and specificity,which can be used in the early diagnosis of sepsis induced by bacterial bloodstream infection.

Purpose To investigate the expression of pFRK protein in non-small cell lung cancer (NSCLC) patients and to explore its prognostic value.Methods The expression of p-FRK protein in tumor tissues and corresponding adjacent normal pulmonary tissues from 162 NSCLC patients was detected by immunohistochemistry of EnVision two-step.The correlation among p-FRK expression,age,gender,clinicopathologic features,pTNM stage and metastasis of NSCLC patients was also analyzed.whether p-FRK could be used as an independent predictor of prognosis for patients with NSCLC was further determined.Results The positive expression rate of p-FRK in NSCLC tissues (51.9％) was significantly higher than that of adjacent normal lung tissues (11.7％) (P =0.001).The expression of p-FRK in NSCLC was significantly correlated with histopathologic type,lymph node status and pTNM stage (P ＜0.05).Kaplan-Meier survival analysis showed that there was a negative correlation between p-FRK positive rate and postoperative overall survival (x2 =17.849,P ＜0.001).Multivariate analysis showed that p-FRK expression was an independent prognostic factor for overall survival of NSCLC patients (HR =0.496,95％ CI:0.295-0.836,P ＜ 0.05).Conclusion As a novel NSCLC biomarker,the expression of p-FRK may predict a poor prognosis in the patients with NSCLC.

Objective To discuss the influence of individualized health education based on combination of TCM and western medicine on the life quality of patients with diabetes mellitus in order to supply novel idea and method for carried out education about diabetes mellitus. Methods Hospitalized patients (140 cases) were randomized into the control group and the test group with 70 cases in each group. Both groups received routine diabetes drugs treatment. The patients and their family members received individualized health education based on combination of TCM and western medicine during their hospitalization days and 6 months after discharge. SF-36 inventory and diabetes cognitive questionnaire was adopted to investigate the two groups. Results The diabetes cognitive degree of the test group was higher than that of the control group (P<0.01). Six items such as social function, systemic health, body pain, psychological health, vigor and emotional role function of the test group was different from those of the control group (P<0.05). Conclusion Individualized health education based on combination of TCM and western medicine contributed to the improvement of patients' life quality.