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 effect of luteolin on angiotensin Ⅱ (Ang Ⅱ)-induced cardiomyocyte hypertrophy in H9c2 cells and to reveal its potential mechanism.Methods:After H9c2 cells were cultured, they were divided into 0, 1, 2 and 4 μmol/L luteolin groups according to different cell treatment conditions. H9c2 cells were stimulated by Ang II to establish a cardiomyocyte hypertrophy model, which was divided into control group, Ang II group and luteolin+Ang II group. Cell survival rates were assessed by cell counting kit-8 assay. The degrees of cell hypertrophy were assessed by phalloidin staining assay. The levels of cellular oxidative stress were assessed by the 2′,7′-dichlorodihydrofluorescein diacetate fluorescent probe assay and thiobarbituric acid assay. The expression of apoptotic protein B-cell lymphoma-2 associated X protein (Bax), cleaved cysteine aspartic acid specific protease-3 (cleaved Caspase-3) and nuclear factor-erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) pathway proteins were assessed by Western blotting. The datas were analyzed by t test and one-way analysis of variance. Results:The survival rates of H9c2 cells in the 0, 1, 2, and 4 μmol/L luteolin group were 97.31%, 95.65%, 94.64%, and 93.27%, respectively. The degree of hypertrophy and the fluorescence intensity of H9c2 cells in Ang Ⅱ group were higher than those in the control group. The degree of hypertrophy and the fluorescence intensity of H9c2 cells in the luteolin+Ang Ⅱ group were lower than those in the Ang Ⅱ group. Compared with the control group, the survival rate of H9c2 cells in Ang Ⅱ group was decreased (96.26% vs 51.68%, P<0.01), the level of malondialdehyde was increased [(1.00±0.08) nmol/mg vs (3.27±0.31) nmol/mg, P<0.01], and the relative expression levels of Bax (0.79±0.04 vs 1.55±0.09, P<0.01), cleaved Caspase-3 (0.11±0.02 vs 1.00±0.04, P<0.01), Nrf2 (0.77±0.04 vs 0.95±0.03, P<0.05), and HO-1 (0.12±0.04 vs 0.41±0.05, P<0.01) were all increased. Compared with Ang Ⅱ group, the survival rate of H9c2 cells in the luteolin+Ang Ⅱ group (81.52%) was increased ( P<0.01), the level of malondialdehyde [(1.73±0.21) nmol/mg] was decreased ( P<0.01), the relative expression levels of Bax (1.25±0.05) and cleaved Caspase-3 (0.48±0.07) were decreased ( P<0.05, 0.01), Nrf2 (1.24±0.13) and HO-1 (0.82±0.03) were increased (both P<0.01). Conclusions:Luteolin effectively inhibits Ang Ⅱ-induced cardiomyocyte hypertrophy through the Nrf2/HO-1 pathway and has potential therapeutic value.

To summarise the nursing experience of caring for a patient with focal segmental glomerulosclerosis for kidney re-transplantation.Nursing key points:early recognition of recurrence of the original disease and rapid activation of emergency response;stabilization of cyclosporine concentration by precision management;optimizing in vitro anticoagulation regimens and vigilance for bleeding and clotting;regulate adrenocorticotropic hormone use and being alert for adverse effects;implementing the whole process of infection prevention and control to prevent infection;implementing the whole process of psychological counseling to alleviate negative emotions.After active treatment and careful care,the patient's transplanted kidney function recovered and was successfully discharged.After a follow-up for 2 months,the patient recovered well.

To summarise the nursing experience of caring for a patient with focal segmental glomerulosclerosis for kidney re-transplantation.Nursing key points:early recognition of recurrence of the original disease and rapid activation of emergency response;stabilization of cyclosporine concentration by precision management;optimizing in vitro anticoagulation regimens and vigilance for bleeding and clotting;regulate adrenocorticotropic hormone use and being alert for adverse effects;implementing the whole process of infection prevention and control to prevent infection;implementing the whole process of psychological counseling to alleviate negative emotions.After active treatment and careful care,the patient's transplanted kidney function recovered and was successfully discharged.After a follow-up for 2 months,the patient recovered well.

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.

OBJECTIVES: Several countries have successfully eliminated measles, and China is making significant strides toward achieving this goal. This study focused on investigating the patterns of measles infections in Zhejiang Province, China, as well as control measures. The objective was to provide valuable insights that could contribute to the development of nationwide elimination strategies. METHODS: We analyzed measles surveillance data from 2005 to 2022 in Zhejiang Province. We utilized a joinpoint regression model to examine trends in measles. Additionally, we employed SaTScan version 9.5 to identify spatial-temporal clusters. Finally, we used an age-period-cohort model to assess the effects of age, period, and cohort. RESULTS: The age-standardized incidence rate (ASIR) of measles infection in Zhejiang Province from 2005 to 2022 was 5.24 per 100,000, showing a consistent and significant downward trend with an annual percentage change of -24.93% (p<0.05). After 2020, the ASIR for measles infection fell to below 0.1 per 100,000. The majority of measles cases occurred in individuals either without an immunization history or with an unknown immunization status, representing 41.06% and 41.40% of the cases from 2010 to 2022, respectively. According to data from the National Measles Surveillance System, the annual rate of discarded measles cases from 2009 to 2014, and the annual rate of discarded measles and rubella cases from 2015 to 2022, were both above 2 per 100,000, indicating the high sensitivity of the measles surveillance system. CONCLUSIONS The significant reduction in measles incidence from 2005 to 2022 demonstrates substantial progress in Zhejiang Province towards the elimination of measles.

To summanze the nursing points of enterostomy among 6 children with small intestinal transplantation,which could provide references for clinical nursing.Key points:to set up a multidisciplinary team and develop an observation plan about enterostomy;to monitor the blood circulation of enterostomy closely,so as to identify the vascular complications as soon as possible;to closely observe the excrement of enterostomy and being vigilant for rejection reaction;to select reasonable nursing supplies based on the situation of enterostomy;to treat the abdominal incision fluid leakage timely,and pay attention to protect the skin around the enterostomy and take measures to control infection;furthermore,to attach great importance to continuous nursing care and improve the quality of home care.After above careful treatment,all the 6 children survived;they were discharged from hospital 3～4 months later after the operation of enterostomy restoration.Followed up 2～4 months,6 children recovered well.

Artificial intelligence has been a huge success and contributes to the workplace. In the digital era, the amount of data in clinical practice is increasing, which requires healthcare workers to integrate and interpret the various information generated during clinical work. With the help of artificial intelligence techniques, especially machine learning techniques, researchers in cardiovascular medicine have developed a variety of predictive models to improve the efficiency of clinical work and treatment outcomes. The types of machine learning models were introduced, and the current prediction models of cardiovascular diseases using machine learning technology were summarized. The purpose of this paper is to facilitate accurate diagnosis of cardiovascular diseases and to provide a clearer direction for future development of cardiovascular disease prediction models using machine learning techniques.

OBJECTIVES: Several countries have successfully eliminated measles, and China is making significant strides toward achieving this goal. This study focused on investigating the patterns of measles infections in Zhejiang Province, China, as well as control measures. The objective was to provide valuable insights that could contribute to the development of nationwide elimination strategies. METHODS: We analyzed measles surveillance data from 2005 to 2022 in Zhejiang Province. We utilized a joinpoint regression model to examine trends in measles. Additionally, we employed SaTScan version 9.5 to identify spatial-temporal clusters. Finally, we used an age-period-cohort model to assess the effects of age, period, and cohort. RESULTS: The age-standardized incidence rate (ASIR) of measles infection in Zhejiang Province from 2005 to 2022 was 5.24 per 100,000, showing a consistent and significant downward trend with an annual percentage change of -24.93% (p<0.05). After 2020, the ASIR for measles infection fell to below 0.1 per 100,000. The majority of measles cases occurred in individuals either without an immunization history or with an unknown immunization status, representing 41.06% and 41.40% of the cases from 2010 to 2022, respectively. According to data from the National Measles Surveillance System, the annual rate of discarded measles cases from 2009 to 2014, and the annual rate of discarded measles and rubella cases from 2015 to 2022, were both above 2 per 100,000, indicating the high sensitivity of the measles surveillance system. CONCLUSIONS The significant reduction in measles incidence from 2005 to 2022 demonstrates substantial progress in Zhejiang Province towards the elimination of measles.

OBJECTIVES: Several countries have successfully eliminated measles, and China is making significant strides toward achieving this goal. This study focused on investigating the patterns of measles infections in Zhejiang Province, China, as well as control measures. The objective was to provide valuable insights that could contribute to the development of nationwide elimination strategies. METHODS: We analyzed measles surveillance data from 2005 to 2022 in Zhejiang Province. We utilized a joinpoint regression model to examine trends in measles. Additionally, we employed SaTScan version 9.5 to identify spatial-temporal clusters. Finally, we used an age-period-cohort model to assess the effects of age, period, and cohort. RESULTS: The age-standardized incidence rate (ASIR) of measles infection in Zhejiang Province from 2005 to 2022 was 5.24 per 100,000, showing a consistent and significant downward trend with an annual percentage change of -24.93% (p<0.05). After 2020, the ASIR for measles infection fell to below 0.1 per 100,000. The majority of measles cases occurred in individuals either without an immunization history or with an unknown immunization status, representing 41.06% and 41.40% of the cases from 2010 to 2022, respectively. According to data from the National Measles Surveillance System, the annual rate of discarded measles cases from 2009 to 2014, and the annual rate of discarded measles and rubella cases from 2015 to 2022, were both above 2 per 100,000, indicating the high sensitivity of the measles surveillance system. CONCLUSIONS The significant reduction in measles incidence from 2005 to 2022 demonstrates substantial progress in Zhejiang Province towards the elimination of measles.