Objective To investigate the clinical efficacy of β-blockers in older patients with hypertension combined with vascular dementia.Methods A total of 152 older patients with hypertension combined with vascular dementia who were admitted to Shanxi Provincial Fenyang Hospital between January 2022 and October 2024 were enrolled.The participants were randomly assigned to either the study group or the control group(76 patients each)using the randomized numerical table method.Both groups received conventional treatment,and the study group received metoprolol for 5 weeks in addition to the conventional treatment.Primary outcome indicators,including changes in systolic blood pressure(SBP)and diastolic blood pressure(DBP)before and after treatment,were examined.Additionally,comparison was made to examine the intergroup difference in serological markers,including high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-8,matrix metalloproteinase 9(MMP-9),homocysteine(Hcy),and superoxide dismutase(SOD)levels,and the scores for intelligence,cognitive,and behavioral assessments.Adverse reactions were recorded.Results After treatment,the study group showed reduced SBP from(146.90±7.35)mmHg(1 mmHg=0.133 kPa)to(120.00±6.03)mmHg and reduced DBP from(90.24±5.97)mmHg to(77.23±6.81)mmHg.The reduction in blood pressure in the study group became more significantly when compared with that of the control group,with intergroup difference in SBP reduction being-8.54 mmHg(P<0.001)and intergroup difference in DBP reduction being-10.80 mmHg(P<0.001).Patients in the 2 groups showed statistically significant differences in the levels of hs-CRP,TNF-α,IL-6,IL-8,MMP-9,and Hcy,and in their cognitive and behavioral scores(P<0.05).No statistically significant differences were found in pulse pressure,von Willebrand factor(vWF)levels,or intelligence scores before and after treatment(P>0.05).The main adverse reactions in the study group were central nervous system reactions(22.37%)and withdrawal syndrome(17.11%).Conclusion The β-blocker metoprolol effectively controlled blood pressure,significantly reduced levels of pro-inflammatory factors and specific vascular injury markers,and improved cognitive function and behavioral symptoms in older patients with hypertension combined with vascular dementia,suggesting its therapeutic efficacy for this condition.However,attention should be paid to its associated adverse reactions.

ObjectiveTo evaluate the efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) for muscle atrophy in patients with immobilization after surgical fixation of foot and ankle fractures.MethodsThis was a two-arm randomized controlled trial wherein 80 patients were recruited and divided into control (n = 40) and intervention (n = 40) groups. The control group received conventional orthopedic treatment, whereas the intervention group received TEAS and conventional treatment. The intervention group received TEAS 3 times a week for 30 min each time for 8 weeks. The primary outcomes were muscle thickness (MT) and cross-sectional area (CSA) of the rectus femoris and gastrocnemius muscles, whereas the secondary outcome measure was echo intensity (EI). Data were collected before the fixation operations (baseline assessment) and 4 and 8 weeks after intervention.ResultsCompared with baseline, the MT and CSA were reduced in both groups by the end of treatment, whereas EI increased in both groups. At week 4, the reduction in the rectus femoris CSA in the intervention group was significantly lower than that in the control group (P = .02); however, the between-group differences in the MT and EI (all P .05) were not significant. No serious adverse events were observed in either group.ConclusionOur study showed that TEAS can improve muscle atrophy by attenuating the decline in the muscle CSA. Because this was only a pilot trial, subsequent studies will need longer follow-ups and larger sample sizes.

Objective To understand the changing composition and antibiotic resistance of bacterial species in the clinical isolates from outpatient and emergency department(hereinafter referred to as outpatients)and inpatient children over time in various hospitals,and to provide laboratory evidence for rational antibiotic use.Methods The data on clinically isolated pathogenic bacteria and antimicrobial susceptibility of isolates from outpatients and inpatient children in the CHINET program from 2015 to 2021 were collected and analyzed.Results A total of 278 471 isolates were isolated from pediatric patients in the CHINET program from 2015 to 2021.About 17.1％of the strains were isolated from outpatients,primarily group A β-hemolytic Streptococcus,Escherichia coli,and Staphylococcus aureus.Most of the strains(82.9％)were isolated from inpatients,mainly SS.aureus,E.coli,and H.influenzae.The prevalence of methicillin-resistant S.aureus(MRSA)in outpatients(24.5％)was lower than that in inpatient children(31.5％).The MRSA isolates from outpatients showed lower resistance rates to the antibiotics tested than the strains isolated from inpatient children.The prevalence of vancomycin-resistant Enterococcus faecalis or E.faecium and penicillin-resistant S.pneumoniae was low in either outpatients or inpatient children.S.pneumoniae,β-hemolytic Streptococcus and S.viridans showed high resistance rates to erythromycin.The prevalence of erythromycin-resistant group A β-hemolytic Streptococcus was higher in outpatients than that in inpatient children.The prevalence of β-lactamase-producing H.influenzae showed an overall upward trend in children,but lower in outpatients(45.1％)than in inpatient children(59.4％).The prevalence of carbapenem-resistant Klebsiella pneumoniae(CRKpn),carbapenem-resistant Pseudomonas aeruginosa(CRPae)and carbapenem-resistant Acinetobacter baumannii(CRAba)was 14％,11.7％,47.8％in outpatients,but 24.2％,20.6％,and 52.8％in inpatient children,respectively.The prevalence of multidrug-resistant E.coli,K.pneumoniae,Proteus mirabilis,P.aeruginosa and A.baumannii strains was lower in outpatients than in inpatient children.The prevalence of fluoroquinolone-resistant E.coli,ESBLs-producing K.pneumoniae,ESBLs-producing P.mirabilis,carbapenem-resistant E.coli(CREco),CRKpn,and CRPae was lower in children in outpatients than in inpatient children,but the prevalence of CRAba in 2021 was higher than in inpatient children.Conclusions The distribution of clinical isolates from children is different between outpatients and inpatients.The prevalence of MRSA,ESBL,and CRO was higher in inpatient children than in outpatients.Antibiotics should be used rationally in clinical practice based on etiological diagnosis and antimicrobial susceptibility test results.Ongoing antimicrobial resistance surveillance and prevention and control of hospital infections are crucial to curbing bacterial resistance.

Objective To investigate the changing antibiotic resistance profiles of E.coli isolated from patients in the 52 hospitals participating in the CHINET program from 2015 to 2021.Methods Antimicrobial susceptibility was tested for clinical isolates of E.coli according to the unified protocol of CHINET program.WHONET 5.6 and SPSS 20.0 software were used for data analysis.Results Atotal of 289 760 nonduplicate clinical strains ofE.coli were isolated from 2015 to 2021,mainly from urine samples(44.7±3.2)％.The proportion of E.coli strains isolated from urine samples was higher in females than in males(59.0％vs 29.5％).The proportion of E.coli strains isolated from respiratory tract and cerebrospinal fluid samples was significantly higher in children than in adults(16.7％vs 7.8％,0.8％vs 0.1％,both P＜0.05).The isolates from internal medicine department accounted for the largest proportion(28.9±2.8)％with an increasing trend over years.Overall,the prevalence of ESBLs-producing E.coli and carbapenem resistant E.coli(CREco)was 55.9％and 1.8％,respectively during the 7-year period.The prevalence of ESBLs-producing E.coli was the highest in tertiary hospitals each year from 2015 to 2021 compared to secondary hospitals.The prevalence of CREco was higher in children's hospitals compared to secondary and tertiary hospitals each year from 2015 to 2021.The prevalence of ESBLs-producing E.coli in tertiary hospitals and children's hospitals and the prevalence of CREco in children's hospitals showed a decreasing trend over the 7-year period.The prevalence of CREco in secondary and tertiary hospitals increased slowly.Antibiotic resistance rates changed slowly from 2015 to 2021.Carbapenem drugs(imipenem,meropenem)were the most active drugs amongβ-lactams against E.coli(resistance rate≤2.1％).The resistance rates of E.coli to β-lactam/β-lactam inhibitor combinations(piperacillin-tazobactam,cefoperazone-sulbactam),aminoglycosides(amikacin),nitrofurantoin and fosfomycin(for urinary isolates only)were all less than 10％.The resistance rate of E.coli strains to antibiotics varied with the level of hospitals and the departments where the strains were isolated,especially for cefazolin and ciprofloxacin,to which the resistance rate of E.coli strains from children in non-ICU departments was significantly lower than that of the strains isolated from other departments(P＜0.05).The E.coli isolates from ICU showed higher resistance rate to most antimicrobial agents tested(excluding tigecycline)than the strains isolated from other departments.The E.coli strains isolated from tertiary hospitals showed higher resistance rates to the antimicrobial agents tested(excluding tigecycline,polymyxin B,cefepime and carbapenems)than the strains from secondary hospitals and children's hospitals.Conclusions E.coli is an important pathogen causing clinical infection.More than half of the clinical isolates produced ESBL.The prevalence of CREco is increasing in secondary and tertiary hospitals over the 7-year period even though the overall prevalence is still low.This is an issue of concern.

Objective: This study aims to explore the association between oral lichen planus (OLP) and Hashimoto’s thyroiditis (HT) and its anti-thyroid antibodies to provide clinical evidence for thyroid disease screening in patients with OLP. Methods: This study was approved by the institutional ethics committee. A total of 125 clinically and histopathologically confirmed patients with OLP were enrolled as the case group, and they were matched with 125 non-OLP controls based on sex and age. Demographic data (gender, age, lesion type, and disease duration) were collected from both groups. Serum levels of thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb) were measured to analyze their associations with sex, age, lesion type, and disease duration in patients with OLP. Result: The prevalence of HT in patients with OLP was 31.20%, significantly higher than that in the control group (9.60%) (χ2=18.504, P<0.001). The prevalence of HT in female patients with OLP (39.13%) was significantly higher than that in male patients (9.09%)（χ2=10.93，P<0.001）. The positivity rate of thyroid peroxidase antibodies (TPOAb) in patients with OLP (17.6%) was significantly higher than in the control group (4.0%) (χ2=10.989, P<0.001). The TPOAb positivity rate was significantly higher in female patients (22.83%) than in male patients (3.03%) (χ2=5.210, P=0.014). There was no statistically significant difference in the positivity rate of TgAb between patients with OLP (7.2%) and the control group (3.2%) (P>0.05). Patients with erosive lesions had a significantly higher TPOAb positivity rate (25.0%, 17/68) compared to those with non-erosive lesions (8.77%, 5/57), and the difference was statistically significant (χ2=4.831, P=0.028). Logistic regression analysis revealed that female patients with OLP had an 8.935-fold higher risk of being TPOAb positive compared to males (OR=8.935, 95%CI: 1.134-70.388, P=0.038). Patients with erosive OLP lesions had a 3.199-fold higher risk of TPOAb positivity compared to those with non-erosive lesions (OR=3.199, 95%CI: 1.064-9.618, P=0.038). Conclusion The prevalence of HT is higher in patients with OLP, with higher positivity rates of anti-thyroid antibodies observed in female patients and those with erosive OLP lesions. This suggests that thyroid disease screening should be incorporated into the clinical management of patients with OLP, especially for women and patients who present with erosive lesions.

Objective To understand the changing composition and antibiotic resistance of bacterial species in the clinical isolates from outpatient and emergency department(hereinafter referred to as outpatients)and inpatient children over time in various hospitals,and to provide laboratory evidence for rational antibiotic use.Methods The data on clinically isolated pathogenic bacteria and antimicrobial susceptibility of isolates from outpatients and inpatient children in the CHINET program from 2015 to 2021 were collected and analyzed.Results A total of 278 471 isolates were isolated from pediatric patients in the CHINET program from 2015 to 2021.About 17.1％of the strains were isolated from outpatients,primarily group A β-hemolytic Streptococcus,Escherichia coli,and Staphylococcus aureus.Most of the strains(82.9％)were isolated from inpatients,mainly SS.aureus,E.coli,and H.influenzae.The prevalence of methicillin-resistant S.aureus(MRSA)in outpatients(24.5％)was lower than that in inpatient children(31.5％).The MRSA isolates from outpatients showed lower resistance rates to the antibiotics tested than the strains isolated from inpatient children.The prevalence of vancomycin-resistant Enterococcus faecalis or E.faecium and penicillin-resistant S.pneumoniae was low in either outpatients or inpatient children.S.pneumoniae,β-hemolytic Streptococcus and S.viridans showed high resistance rates to erythromycin.The prevalence of erythromycin-resistant group A β-hemolytic Streptococcus was higher in outpatients than that in inpatient children.The prevalence of β-lactamase-producing H.influenzae showed an overall upward trend in children,but lower in outpatients(45.1％)than in inpatient children(59.4％).The prevalence of carbapenem-resistant Klebsiella pneumoniae(CRKpn),carbapenem-resistant Pseudomonas aeruginosa(CRPae)and carbapenem-resistant Acinetobacter baumannii(CRAba)was 14％,11.7％,47.8％in outpatients,but 24.2％,20.6％,and 52.8％in inpatient children,respectively.The prevalence of multidrug-resistant E.coli,K.pneumoniae,Proteus mirabilis,P.aeruginosa and A.baumannii strains was lower in outpatients than in inpatient children.The prevalence of fluoroquinolone-resistant E.coli,ESBLs-producing K.pneumoniae,ESBLs-producing P.mirabilis,carbapenem-resistant E.coli(CREco),CRKpn,and CRPae was lower in children in outpatients than in inpatient children,but the prevalence of CRAba in 2021 was higher than in inpatient children.Conclusions The distribution of clinical isolates from children is different between outpatients and inpatients.The prevalence of MRSA,ESBL,and CRO was higher in inpatient children than in outpatients.Antibiotics should be used rationally in clinical practice based on etiological diagnosis and antimicrobial susceptibility test results.Ongoing antimicrobial resistance surveillance and prevention and control of hospital infections are crucial to curbing bacterial resistance.

Objective To investigate the changing antibiotic resistance profiles of E.coli isolated from patients in the 52 hospitals participating in the CHINET program from 2015 to 2021.Methods Antimicrobial susceptibility was tested for clinical isolates of E.coli according to the unified protocol of CHINET program.WHONET 5.6 and SPSS 20.0 software were used for data analysis.Results Atotal of 289 760 nonduplicate clinical strains ofE.coli were isolated from 2015 to 2021,mainly from urine samples(44.7±3.2)％.The proportion of E.coli strains isolated from urine samples was higher in females than in males(59.0％vs 29.5％).The proportion of E.coli strains isolated from respiratory tract and cerebrospinal fluid samples was significantly higher in children than in adults(16.7％vs 7.8％,0.8％vs 0.1％,both P＜0.05).The isolates from internal medicine department accounted for the largest proportion(28.9±2.8)％with an increasing trend over years.Overall,the prevalence of ESBLs-producing E.coli and carbapenem resistant E.coli(CREco)was 55.9％and 1.8％,respectively during the 7-year period.The prevalence of ESBLs-producing E.coli was the highest in tertiary hospitals each year from 2015 to 2021 compared to secondary hospitals.The prevalence of CREco was higher in children's hospitals compared to secondary and tertiary hospitals each year from 2015 to 2021.The prevalence of ESBLs-producing E.coli in tertiary hospitals and children's hospitals and the prevalence of CREco in children's hospitals showed a decreasing trend over the 7-year period.The prevalence of CREco in secondary and tertiary hospitals increased slowly.Antibiotic resistance rates changed slowly from 2015 to 2021.Carbapenem drugs(imipenem,meropenem)were the most active drugs amongβ-lactams against E.coli(resistance rate≤2.1％).The resistance rates of E.coli to β-lactam/β-lactam inhibitor combinations(piperacillin-tazobactam,cefoperazone-sulbactam),aminoglycosides(amikacin),nitrofurantoin and fosfomycin(for urinary isolates only)were all less than 10％.The resistance rate of E.coli strains to antibiotics varied with the level of hospitals and the departments where the strains were isolated,especially for cefazolin and ciprofloxacin,to which the resistance rate of E.coli strains from children in non-ICU departments was significantly lower than that of the strains isolated from other departments(P＜0.05).The E.coli isolates from ICU showed higher resistance rate to most antimicrobial agents tested(excluding tigecycline)than the strains isolated from other departments.The E.coli strains isolated from tertiary hospitals showed higher resistance rates to the antimicrobial agents tested(excluding tigecycline,polymyxin B,cefepime and carbapenems)than the strains from secondary hospitals and children's hospitals.Conclusions E.coli is an important pathogen causing clinical infection.More than half of the clinical isolates produced ESBL.The prevalence of CREco is increasing in secondary and tertiary hospitals over the 7-year period even though the overall prevalence is still low.This is an issue of concern.

Background and objective Lung cancer is the malignant tumor with the highest incidence rate and the heaviest disease burden in China.In recent years,lung cancer has shown a high incidence trend,seriously affecting the health of the population.In this paper,we analyze the characteristics of lung cancer incidence in 2019 and the trend of incidence rate from 2010-2019 in the tumor registration area of Gansu province,in order to provide a reference basis for the development of lung cancer prevention and control strategies in Gansu province.Methods By analyzing the cases of lung cancer incidence in the tumor registration area of Gansu province in 2019,we calculated the incidence rate,medium incidence rate,world in-cidence rate and other related indexes;we used Joinpoint to calculate the annual percentage change(APC)for trend analysis.Results In 2019,a total of 3757 new cases of lung cancer were reported in Gansu province,accounting for 14.96%of all new malignant tumors.The incidence rate,medium incidence rate and world incidence rate and world rate of lung cancer were 40.52/105,25.78/105,25.86/105;and the cumulative rate of 0-74 years old,and the truncation rate of 35-64 years old were 3.23%,40.03/105,respectively.The incidence of lung cancer rises with age,and is high in the age group of 40 years and above,and the incidence peaks in the male and female populations in the group of 75 years and above,and the group of 80 years and above,respectively.The crude incidence rate of lung cancer in the tumor registration area of Gansu province from 2010-2019 showed an overall increasing trend,and the rate of increase was relatively fast,with an APC 5.39%(P<0.05);Separately,accord-ing to gender,urban and rural areas,the incidence of lung cancer in all populations showed an increasing trend,and the APC of male,female,urban and rural populations were 4.98%,6.39%,6.26%,and 4.64%,respectively(all P<0.05).According to the trend analysis of lung cancer incidence rate by age group,only lung cancer incidence in the age group of 65 years and above increased at an annual average rate of 4.15%(P<0.05).Conclusion The incidence rate of lung cancer in the tumor registration area of Gansu province from 2010 to 2019 shows a rising trend year by year,and there are differences in the incidence of lung cancer in people of different genders,regions and age groups,so comprehensive prevention and control work should be carried out for the key populations of lung cancer incidence.

Objective To investigate the distribution and antimicrobial resistance profiles of the clinical isolates from wound pus in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Methods All the bacterial strains were isolated from wound pus samples from 2015 to 2021.The isolates were identified according to conventional methods.Antimicrobial susceptibility test was conducted by disk diffusion method or commercial automated susceptibility testing systems according to CHINET-specified uniform protocol.The results are interpreted according to the Clinical and Laboratory Standards Institute (CLSI) breakpoints (2021 Edition).Results A total of 90856 bacterial strains were isolated from wound pus samples from 2015 to 2021,of which gram positive bacteria accounted for 36.0％ (32729/90856) and gram negative bacteria accounted for 64.0％ (58127/90856).The most common bacterial species were Escherichia coli,Staphylococcus aureus,Klebsiella pneumoniae,Pseudomonas aeruginosa,and Enterococcus.About 88.9％ of these strains were isolated from inpatients and 11.1％ from outpatients.The strains collected from surgery department and internal medicine accounted for (53.4±3.6)％ (49191/90856) and (9.6±1.0)％ (8960/90856) on average over the 7-year period.E.coli showed low level resistance to carbapenems (1.1％).The prevalence of ESBLs-producing E.coli was 51.1％.More than 35％ of the E.coli isolates were resistant to cefotaxime,ciprofloxacin,and trimethoprim-sulfamethoxazole.The prevalence of ESBLs-producing K.pneumoniae was 29.7％.The prevalence of imipenem-resistant and meropenem-resistant K.pneumoniae varied from 2015 to 2021,but reached the peak level (12.5％ and 12.7％) in 2020.However,other Enterobacterales species showed low resistance rates to carbapenems.The prevalence of ESBLs-producing Klebsiella oxytoca and Proteus was 18.3％ and 32.5％,respectively.About 13.1％ and 10.6％ of P.aeruginosa isolates were resistant to imipenem and meropenem,respectively.However,71.1％ and 72.4％ of A.baumannii isolates were resistant to imipenem and meropenem,respectively.The overall prevalence of MRSA was 22.7％ in wound pus samples over the 7-year period.Three vancomycin-resistant strains and 122 linezolid-resistant isolates were identified in Enterococcus faecalis.Thirty-one vancomycin-resistant strains and 11 linezolid-resistant strains were detected in Enterococcus faecium.Conclusions The overall prevalence of MRSA,vancomycin-resistant Enterococcus (VRE),linezolid-resistant Enterococcus (LRE),ESBLs-producing Enterobacterales,and carbapenem-resistant organisms (CRO) in the isolates from wound pus samples was relatively lower than the corresponding prevalence in the total clinical isolates collected in the CHINET program.This finding suggests that the antimicrobial resistance profile of bacterial isolates may vary with the source of clinical samples.Therefore,we should strengthen the antimicrobial resistance surveillance for the isolates from different sites of infection.

Objective To investigate the distribution and antimicrobial resistance profiles of the clinical isolates from wound pus in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Methods All the bacterial strains were isolated from wound pus samples from 2015 to 2021.The isolates were identified according to conventional methods.Antimicrobial susceptibility test was conducted by disk diffusion method or commercial automated susceptibility testing systems according to CHINET-specified uniform protocol.The results are interpreted according to the Clinical and Laboratory Standards Institute (CLSI) breakpoints (2021 Edition).Results A total of 90856 bacterial strains were isolated from wound pus samples from 2015 to 2021,of which gram positive bacteria accounted for 36.0％ (32729/90856) and gram negative bacteria accounted for 64.0％ (58127/90856).The most common bacterial species were Escherichia coli,Staphylococcus aureus,Klebsiella pneumoniae,Pseudomonas aeruginosa,and Enterococcus.About 88.9％ of these strains were isolated from inpatients and 11.1％ from outpatients.The strains collected from surgery department and internal medicine accounted for (53.4±3.6)％ (49191/90856) and (9.6±1.0)％ (8960/90856) on average over the 7-year period.E.coli showed low level resistance to carbapenems (1.1％).The prevalence of ESBLs-producing E.coli was 51.1％.More than 35％ of the E.coli isolates were resistant to cefotaxime,ciprofloxacin,and trimethoprim-sulfamethoxazole.The prevalence of ESBLs-producing K.pneumoniae was 29.7％.The prevalence of imipenem-resistant and meropenem-resistant K.pneumoniae varied from 2015 to 2021,but reached the peak level (12.5％ and 12.7％) in 2020.However,other Enterobacterales species showed low resistance rates to carbapenems.The prevalence of ESBLs-producing Klebsiella oxytoca and Proteus was 18.3％ and 32.5％,respectively.About 13.1％ and 10.6％ of P.aeruginosa isolates were resistant to imipenem and meropenem,respectively.However,71.1％ and 72.4％ of A.baumannii isolates were resistant to imipenem and meropenem,respectively.The overall prevalence of MRSA was 22.7％ in wound pus samples over the 7-year period.Three vancomycin-resistant strains and 122 linezolid-resistant isolates were identified in Enterococcus faecalis.Thirty-one vancomycin-resistant strains and 11 linezolid-resistant strains were detected in Enterococcus faecium.Conclusions The overall prevalence of MRSA,vancomycin-resistant Enterococcus (VRE),linezolid-resistant Enterococcus (LRE),ESBLs-producing Enterobacterales,and carbapenem-resistant organisms (CRO) in the isolates from wound pus samples was relatively lower than the corresponding prevalence in the total clinical isolates collected in the CHINET program.This finding suggests that the antimicrobial resistance profile of bacterial isolates may vary with the source of clinical samples.Therefore,we should strengthen the antimicrobial resistance surveillance for the isolates from different sites of infection.