Objective To understand the distribution and antimicrobial resistance profiles of bacterial strains isolated from blood cultures at Yunyang County People's Hospital from 2019 to 2023.Methods The data of bacterial isolates from blood samples and the results of antimicrobial susceptibility testing were analyzed retrospectively from 2019 to 2023 at Yunyang County People's Hospital.Results A total of 3 789 bacterial strains were isolated from blood culture,including 1 931(51.0％)strains of Gram negative bacteria and 1 858(49.0％)strains of Gram positive bacteria.Coagulase negative Staphylococcus(33.3％),Escherichia coli(25.4％),Klebsiella pneumoniae(13.7％),Staphylococcus aureus(9.9％),and Enterobacter cloacae(1.8％)were the top five bacterial pathogens.Antimicrobial susceptibility testing showed that the prevalence of methicillin-resistant strains was 27.1％in S.aureus,34.5％in S.epidermidis,and 49.9％in other coagulase-negative Staphylococcus.Methicillin resistant strains(MRSA,MRSE,and other MRCNS)showed significantly higher resistance rates to most antibiotics than corresponding methicillin-susceptible strains(MSSA,MSSE,and other MSCNS).No staphylococcal isolates were resistant to vancomycin,teicoplanin,linezolid,or tigecycline.Enterococcus faecium showed significantly higher resistance rate to antibiotics than Enterococcus faecalis.No enterococcal strains were resistant to vancomycin,teicoplanin,linezolid,or tigecycline.No streptococcal isolates were found resistant to vancomycin or linezolid.Serratia marcescens strains had a resistance rate of 25.0％to carbapenems.All other Enterobacterales species showed a resistance rate of less than 10.0％to carbapenems.No Enterobacterales isolates were found resistant to tigecycline.The resistance rates of P.aeruginosa to imipenem and meropenem were 5.7％and 3.8％,respectively.No P.aeruginosa isolates were found resistant to colistin.The resistance rates of Acinetobacter baumannii to imipenem and meropenem were 41.4％and 38.0％,respectively.Conclusions The proportion of Gram negative bacteria is slightly higher than that of Gram positive bacteria in the bacterial isolates from blood samples at Yunyang County People's Hospital.The prevalence of MRSA and MRCNS is relatively high,while A.baumannii and S.marcescens showed high resistance rates to carbapenems.Antimicrobial resistance surveillance should be strengthened for the bacterial isolates from blood samples in order to learn the changing resistance profiles,use antibiotics reasonably,and prevent the spread of drug-resistant bacteria.

Objective This study quantitatively analyzed the initial displacement and stress distribution of maxillary teeth and periodontal ligaments(PDLs)under different traction positions of Class Ⅱ elastics in the anterior region of fixed multibracket appliances,aiming to provide references for the optimal application of Class Ⅱ elastics.Methods A finite element model of the maxilla with Class Ⅱ elastics was established.Based on whether tooth extraction was performed and the traction positions of Class Ⅱ elastics in the maxillary anterior region,the models were divided into 4 groups and 8 working conditions.A 1.2 N load was applied between the maxillary anterior region and the tube of the mandibular first molar.The initial displacement of maxillary teeth and the von Mises stress of maxillary PDLs were analyzed.Results The finite element model of the maxilla with Class Ⅱelastics was successfully constructed.Class Ⅱ elastics induced lingual inclination,eruption,and retraction of maxillary anterior teeth.Variations in the traction positions of Class Ⅱ elastics resulted in differences in the initial displacement of maxillary teeth and the von Mises stress of PDLs.The maximum von Mises stress of PDLs ranged from 5.8 to 12.2 kPa across all working conditions.Conclusions Different traction positions of Class Ⅱelastics alter the torque,induce distinct deformation trends in the archwire,and thus affect tooth movement.Compared with attaching Class Ⅱ elastics to the maxillary canine bracket,attaching them to the hooks increases the tendency toward deep overbite,and this tendency is more pronounced in extraction models.For patients with Class Ⅱ,Division 1 malocclusion,anterior tooth protrusion,and a tendency toward open bite,applying Class Ⅱelastics on the occlusal side of the hooks may be more beneficial in alleviating open bite and enhancing the smile arc.However,the actual efficacy requires clinical verification.

Objective This study quantitatively analyzed the initial displacement and stress distribution of maxillary teeth and periodontal ligaments(PDLs)under different traction positions of Class Ⅱ elastics in the anterior region of fixed multibracket appliances,aiming to provide references for the optimal application of Class Ⅱ elastics.Methods A finite element model of the maxilla with Class Ⅱ elastics was established.Based on whether tooth extraction was performed and the traction positions of Class Ⅱ elastics in the maxillary anterior region,the models were divided into 4 groups and 8 working conditions.A 1.2 N load was applied between the maxillary anterior region and the tube of the mandibular first molar.The initial displacement of maxillary teeth and the von Mises stress of maxillary PDLs were analyzed.Results The finite element model of the maxilla with Class Ⅱelastics was successfully constructed.Class Ⅱ elastics induced lingual inclination,eruption,and retraction of maxillary anterior teeth.Variations in the traction positions of Class Ⅱ elastics resulted in differences in the initial displacement of maxillary teeth and the von Mises stress of PDLs.The maximum von Mises stress of PDLs ranged from 5.8 to 12.2 kPa across all working conditions.Conclusions Different traction positions of Class Ⅱelastics alter the torque,induce distinct deformation trends in the archwire,and thus affect tooth movement.Compared with attaching Class Ⅱ elastics to the maxillary canine bracket,attaching them to the hooks increases the tendency toward deep overbite,and this tendency is more pronounced in extraction models.For patients with Class Ⅱ,Division 1 malocclusion,anterior tooth protrusion,and a tendency toward open bite,applying Class Ⅱelastics on the occlusal side of the hooks may be more beneficial in alleviating open bite and enhancing the smile arc.However,the actual efficacy requires clinical verification.

Nanchang University and Queen Mary University of London have integrated their educational and teaching advantageous resources to establish a Sino-foreign cooperative clinical medicine program in China. The program awards the degrees of Bachelor of Science in Biomedical Sciences and Bachelor of Clinical Medicine, aiming to cultivate well-rounded medical talents with both clinical and scientific research capabilities and an international perspective. By introducing biomedical courses and integrating them with basic medical courses, the program emphasizes basic knowledge, practical training, active learning, and the cultivation of scientific research skills and critical thinking ability. The evaluation parameters include academic output, innovation competitions, and the number of students pursuing graduate education. The results showed substantial increases in the number of SCI academic articles published by students in this program, the number of awards in innovation competitions, and the number of students pursuing graduate education. This program is a new attempt in the reform of medical education in China.

Objective To understand the distribution and antimicrobial resistance profiles of bacterial strains isolated from blood cultures at Yunyang County People's Hospital from 2019 to 2023.Methods The data of bacterial isolates from blood samples and the results of antimicrobial susceptibility testing were analyzed retrospectively from 2019 to 2023 at Yunyang County People's Hospital.Results A total of 3 789 bacterial strains were isolated from blood culture,including 1 931(51.0％)strains of Gram negative bacteria and 1 858(49.0％)strains of Gram positive bacteria.Coagulase negative Staphylococcus(33.3％),Escherichia coli(25.4％),Klebsiella pneumoniae(13.7％),Staphylococcus aureus(9.9％),and Enterobacter cloacae(1.8％)were the top five bacterial pathogens.Antimicrobial susceptibility testing showed that the prevalence of methicillin-resistant strains was 27.1％in S.aureus,34.5％in S.epidermidis,and 49.9％in other coagulase-negative Staphylococcus.Methicillin resistant strains(MRSA,MRSE,and other MRCNS)showed significantly higher resistance rates to most antibiotics than corresponding methicillin-susceptible strains(MSSA,MSSE,and other MSCNS).No staphylococcal isolates were resistant to vancomycin,teicoplanin,linezolid,or tigecycline.Enterococcus faecium showed significantly higher resistance rate to antibiotics than Enterococcus faecalis.No enterococcal strains were resistant to vancomycin,teicoplanin,linezolid,or tigecycline.No streptococcal isolates were found resistant to vancomycin or linezolid.Serratia marcescens strains had a resistance rate of 25.0％to carbapenems.All other Enterobacterales species showed a resistance rate of less than 10.0％to carbapenems.No Enterobacterales isolates were found resistant to tigecycline.The resistance rates of P.aeruginosa to imipenem and meropenem were 5.7％and 3.8％,respectively.No P.aeruginosa isolates were found resistant to colistin.The resistance rates of Acinetobacter baumannii to imipenem and meropenem were 41.4％and 38.0％,respectively.Conclusions The proportion of Gram negative bacteria is slightly higher than that of Gram positive bacteria in the bacterial isolates from blood samples at Yunyang County People's Hospital.The prevalence of MRSA and MRCNS is relatively high,while A.baumannii and S.marcescens showed high resistance rates to carbapenems.Antimicrobial resistance surveillance should be strengthened for the bacterial isolates from blood samples in order to learn the changing resistance profiles,use antibiotics reasonably,and prevent the spread of drug-resistant bacteria.

Nanchang University and Queen Mary University of London have integrated their educational and teaching advantageous resources to establish a Sino-foreign cooperative clinical medicine program in China. The program awards the degrees of Bachelor of Science in Biomedical Sciences and Bachelor of Clinical Medicine, aiming to cultivate well-rounded medical talents with both clinical and scientific research capabilities and an international perspective. By introducing biomedical courses and integrating them with basic medical courses, the program emphasizes basic knowledge, practical training, active learning, and the cultivation of scientific research skills and critical thinking ability. The evaluation parameters include academic output, innovation competitions, and the number of students pursuing graduate education. The results showed substantial increases in the number of SCI academic articles published by students in this program, the number of awards in innovation competitions, and the number of students pursuing graduate education. This program is a new attempt in the reform of medical education in China.

Public hospitals play a dominant role in providing medical services.Meanwhile,they are also critical for un-dertaking missions to handle health emergencies.This paper analyzes the necessity,current situation,and existing weaknesses of the health emergency capacity of public hospitals.It also conducts a comparative study of the emergency response mechanisms of foreign medical institutions.This paper aims to explore a well-developed design for health emergency in public hospitals that is suitable for China's medical conditions and to provide a feasible model for promoting high-quality health emergency management.

Objective To explore the therapeutic efficacy of automatic peritoneal dialysis on elderly patients with cardiorenal syndrome(CRS).Methods A total of 260 elderly CRS patients treated at our hospital from January 2019 to January 2022 were recruited,and then randomly divided into an observation group and a control group,with 130 cases in each group.The control group received conventional basic treatment and symptomatic treatment,while the observation group received automated peritoneal dialysis treatment on this basis.Cardiac function indicators,renal function indicators,inflammatory factors,MAP and heart rate were compared between the two groups.Re-sults After treatment,significantly lower LVESD(26.29±1.19 mm vs 29.59±1.84 mm),LVEDD(47.43±1.39 mm vs 51.81±1.34 mm),LAD(30.74±1.15 mm vs 33.11±0.88 mm),and levels of NT-proBNP(1034.74±313.61 ng/L vs 2634.02±853.67 ng/L),urea(16.69±3.57 mmol/L vs 32.67±4.54 mmol/L),cystatin C(0.47±0.13 mg/L vs 0.61±0.15 mg/L),creatinine(254.74±41.15 mmol/L vs 394.09±38.61 mmol/L),TNF-α(144.14±23.16 mg/L vs 183.97± 23.37 mg/L)and hs-CRP(4.09±1.03 μg/L vs 5.45±1.17 μg/L),and higher LVEF(39.14± 4.48％vs 35.64±5.27％)were observed in the observation group than the control group(all P＜0.01).There were no significant differences in heart rate and MAP between the two groups before and after treatment(P＞0.05).Conclusion Automatic peritoneal dialysis can improve the cardiac and renal function and reduce inflammatory response in elderly CRS patients,and show positive significance for improving prognosis.

Objective:To summarize and analyze the clinical outcome of minimally invasive McKeown esophagectomy for esophageal squamous cell carcinoma.Methods:We retrospectively analyzed the clinical data of patients with esophageal squamous cell carcinoma who received minimally invasive McKeown esophagectomy in Peking Union Medical College Hospital from January 2017 to December 2022. Improved anesthesia methods, monitoring of recurrent laryngeal nerve, minimally invasive gastrostomy, and jejunostomy techniques were introduced in surgical procedure. We evaluated perioperative data and long-term follow-up survival in these patients.Results:A total of 226 esophageal squamous cell carcinoma patients who met the inclusion and exclusion criteria were enrolled, of which 48.2% received neoadjuvant therapy. The mean operation time was( 327 ± 68) min, with a total of 40.5(33, 50) lymph nodes and 27(19, 33) thoracic lymph nodes harvested. The postoperative hospital stay was 9(7, 12) days, and the postoperative complication rate was 36.3%. In terms of learning curve, after 50 patients intraoperative blood loss, postoperative hospital stay, and recurrent laryngeal nerve injury rate were significantly decreased. The number of total lymph nodes, thoracic lymph nodes, and the 106tbl harvested was significantly increased. The median follow-up time was 23.5(14, 47) months, with a loss of follow-up rate of 3.5%. The overall 2-year and 5-year survival rates were 82.6% and 71.8%, respectively.Conclusion:Improved minimally invasive McKeown esophagectomy for esophageal squamous cell carcinoma are safe and acceptable. Learning curve can be shortened, with increased lymph node harvested and decreased postoperative complications, which improving the short-term and long-term outcomes of patients.