ObjectiveTo understand the infection characteristics of multidrug-resistant organisms (MDROs) in hospitalized patients in a tertiary sentinel hospital in Shanghai, so as to provide an evidence for the development of targeted prevention and control measures. MethodsData of MDROs strains and corresponding medical records of some hospitalized patients in a hospital in Shanghai from 2021 to 2023 were collected, together with an analysis of the basic information, clinical treatment, underlying diseases and sources of sample collection. ResultsA total of 134 strains of MDROs isolated from hospitalized patients in this hospital were collected from 2021 to 2023 , including 63 strains of methicillin-resistant Staphylococcus aureus (MRSA), 57 strains of carbapenem-resistant Acinetobacter baumannii (CRAB), and 14 strains of carbapenem-resistant Klebsiella pneumoniae (CRKP). Of the 134 strains, 30 strains were found in 2021, 47 strains in 2022 and 57 strains in 2023. The male-to-female ratio of patients was 2.05∶1, with the highest percentage (70.90%) in the age group of 60‒<90 years. The primary diagnosis was mainly respiratory disease, with lung and respiratory tract as the cheif infection sites. There was no statistically significant difference in the distribution of strains between different genders and infection sites (P>0.05). However, the differences in the distribution of strains between different ages and primary diagnosis were statistically significant (P<0.05). Patients who were admitted to the intensive care unit (ICU), had urinary tract intubation, were not artery or vein intubated, were not on a ventilator, were not using immunosuppresants or hormones, and were not applying radiotherapy or chemotherapy were in the majority. There was no statistically significant difference in the distribution of strains for whether received radiotherapy or chemotherapy or not (P>0.05), while the differences in the distribution of strains with ICU admission history, urinary tract intubation, artery or vein intubation, ventilator use, and immunosuppresants or hormones use or not were statistically significant (all P<0.05). The type of specimen was mainly sputum, the hospitalized ward was mainly comprehensive ICU, the sampling time was mainly in the first quarter throughout the year, the number of underlying diseases was mainly between 1 to 2 kinds, the application of antibiotics ≥4 kinds, and those who didn’t receive any surgery recently accounted for the most. There were statistically significant differences in the distribution of strains between different specimen types, wards occupied and history of ICU stay (P<0.05), but no statistically significant difference in the distribution of strains between different sampling times, number of underlying diseases and types of antibiotics applied (P>0.05). ConclusionThe situation of prevention and control on MDROs in this hospital is still serious. Focus should be placed on high-risk factors’ and infection monitoring and preventive measures should be strengthened to reduce the incidence rate of MDROs infection.

Rabies is an acute infectious disease caused by rabies virus with a high fatality rate. Post-exposure human rabies vaccination is an important measure to reduce the risk of rabies. Rabies vaccine is mainly used for post-exposure immunization with safety and tolerance. However, adverse reactions may occur in some recipients, mainly including local reactions such as pain, redness and swelling, and systemic reactions such as fever and headache. Usually, the symptoms are mild and self-limited, but severe adverse reactions in allergic patients may be life-threatening. The occurrence of adverse reactions to rabies vaccine for human use is closely related to individual differences, vaccine production process, and vaccination factors. The articles on adverse reaction of rabies vaccine for human use published in CNKI and PubMed database from 2006 to 2024 were retrieved. The incidence, causes and countermeasures of adverse reaction of rabies vaccine for human use were reviewed, so as to provide reference for reducing adverse reactions of rabies vaccine.

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

Objective To investigate the expression of dermatopontin(DPT)in abdominal aortic aneurysm(AAA)and to explore the mechanism in promoting AAA progression.Methods Differential gene expression(DEG)and GO-KEGG pathway enrichment were used to assess DPT expression level and related pathways in AAA.AAA tissue samples were collected from patients undergoing open surgical repair at Beijing Hospital(experimental group,n=3),while control aortic tissues were collected from kidney transplant donors(n=3).Immun-ohistochemistry and immuno-fluorescence staining were performed to validate DPT protein expression differences in AAA tissues.Masson staining microscopy was used to evaluate fibrosis level.Human aortic smooth muscle cells(HASMCs)were divided into control(Ctrl)and lipopolysaccharide(LPS)-treated groups(n=3).RT-qPCR,ELISA,and immu-nocytochemistry(ICC)were used to measure DPT expression level.HASMCs were further divided into control(Ctrl)and recombinant human DPT-treated groups with 3 cases in each.RT-qPCR was performed to detect the ex-pression of interleukin-1α(IL-1α),interleukin-1β(IL-1β),collagen type Ⅰ alpha 1 chain(COL1A1),matrix metalloproteinase-2(MMP2),and matrix metalloproteinase-9(MMP9).Cell adhesion assays were conducted to ex-amine the role of integrin α3 and integrin β1 in HASMC adhesion.Results DPT was highly expressed in human AAA tissues(P＜0.01).LPS induced DPT expression and secretion in HASMCs(P＜0.05).DPT promoted IL-1α(P＜0.001)and IL-1β(P＜0.01)expression through a positive feedback mechanism while suppressed COL1A1(P＜0.001)production.DPT enhanced HASMC adhesion via the integrin α3β1 receptor(P＜0.001).Conclusions DPT promotes AAA progression by activating IL-1α/IL-1β inflammatory cytokines and inhibits COL1A1-mediated extra cellular matrix(ECM)remodeling.Integrin α3β1 is potentially involved in the regulation process.

Objective To design and synthesize dual-target antidepressant compounds possessing high-affinity binding to the serotonin 1A receptor(5-HT1A)and dual-site synergistic inhibition of the serotonin transporter(SERT).Methods Based on a dual-target synergistic mechanism,benzodioxolane derivatives were designed via scaffold hopping strategy before being synthesized.Their binding affinities to both targets were determined via competitive radioligand binding assays,and their binding modes were investigated using molecular docking.Results Eleven structurally novel target compounds were synthesized and structurally characterized by electrospray ionization mass spectrometry(ESI-MS)and nuclear magnetic resonance(NMR)spectroscopy.Compound 18b demonstrated dual nanomolar affinity for both the 5-HT1A receptor(Ki=2.72 nmol/L)and SERT(Ki=8.85 nmol/L).Molecular docking revealed that its inhibitory effect on SERT resulted from simultaneous occupation of the orthosteric site S1(Asp98 salt bridge)and the allosteric site S2(Arg104 rr-cation interaction),while its high affinity for 5-HT1A depended on the Asp116332 salt bridge anchor and π-π stacking with Phe362652.Conclusion The benzodioxolane-scaffold compounds designed and synthesized in this study exhibited functional synergy between simultaneous occupation of both the S1 and S2 sites of SERT and high-affinity binding to the 5-HT1Areceptor.Among them,compound 18b demonstrates superior activity and promises to be a lead compound for more investigation.

Objective: To understand the interrelationships of parental control, peer relationship, and aggressive behavior in junior high school students, in order to provide a theoretical basis for preventing the occurrence of adolescent aggressive behavior. Methods: During June to July, 2022, 2 564 students of grade one to grade three were selected from 6 junior high schools from each of Suzhou and Xuancheng cities in Anhui Province by using convenient cluster random sampling method, and then the questionnaire survey was administered, including the Chinese version of Parent Control Questionnaire, Chinese version of Buss & Perry Aggression Questionnaire and Adolescent Peer Relationship Questionnaire. Results: Boys scored (185.31±27.49, 21.65±7.43, 21.77 ±8.18, 69.50±11.41, 72.39±11.53) higher than girls (178.21±25.13, 20.08±7.09, 20.61±7.62, 66.56± 11.14 , 70.95± 11.84 ) in parental control, father s psychological control, mother s psychological control, father s behavioral control, and mother s behavioral control ( t =8.63, 5.47, 3.70, 6.60, 3.12), while girls scored (48.41±11.26) higher in peer relationship than boys ( 47.13 ± 10.84 ) ( t =-2.95) ( P <0.01). The scores of first grade students in parental control, father s psychological control, mother s psychological control, father s behavior control, peer relationship, and aggressive behavior (184.67±27.18, 21.83± 7.29 , 22.15±8.07, 68.81±10.95, 50.21±9.57, 80.23±17.66) were higher than those of second gradestudents (180.98±25.46, 20.16±7.82, 20.21±7.55, 68.29±11.69, 45.47±11.67, 74.08±17.70) and third grade students (179.21±26.79, 20.53±7.22, 21.17 ± 8.06 , 66.81± 11.39 , 47.54±11.43, 75.75±16.29) ( F =9.44, 12.87, 13.61, 6.84, 42.85, 30.40, P <0.01). The scores of parental control and peer relationship were positively correlated with the scores of aggressive behavior ( r=0.22, 0.47, P <0.01). Peer relationship partially mediate the relationship between parental control and aggressive behavior, with a partial mediation effect value of 0.04, accounting for 26.39% of the total effect of parental control on aggressive behavior. Conclusions High parental control and poor peer relationship are both positively correlated with the level of aggressive behavior. The peer relationship of teenagers should be improved by establishing appropriate parenting style, tackling campus violence, and maintaining good social norms, in order to reduce the occurrence of aggressive behavior among adolescents.

Objective:To explore the impact of baseline remnant cholesterol levels at a single time point and cumulative remnant cholesterol exposure on the progression trajectories of arterial stiffness.Methods:This prospective cohort study included 2 401 eligible participants from the Beijing Health Management Cohort who consecutively attended health examinations in 2010-2011, 2012-2013, and 2014-2015. The remnant cholesterol value measured in 2014-2015 served as the baseline remnant cholesterol level at a single time point. The cumulative exposure indices were calculated based on remnant cholesterol values from three health examinations from 2010 to 2015, including cumulative exposure, cumulative exposure burden, and duration of high remnant cholesterol exposure. Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV). The follow-up continued until December 31, 2019, with annual check-ups. During the follow-up period, a group-based trajectory model was employed to construct the progression trajectories of baPWV. The associations between the baseline remnant cholesterol level, cumulative exposure indices of remnant cholesterol and baPWV trajectories were examined using ordinal logistic regression models, adjusting for traditional cardiovascular risk factors and low-density lipoprotein cholesterol (LDL-C) levels.Results:The age of the 2 401 participants was 61 (54, 69) years, with 1 801 (75.01%) being male. The group-based trajectory model indicated that the best-fit model categorized the participants into three subgroups: low-rising group (1 036 individuals, 43.15%), moderate-rising group (1 137 individuals, 47.36%), and high-rising group (228 individuals, 9.50%). After adjusting for traditional cardiovascular risk factors, baseline remnant cholesterol levels at a single point ( OR=1.170, 95% CI: 1.074-1.274), cumulative remnant cholesterol exposure ( OR=1.194, 95% CI: 1.096-1.303), cumulative remnant cholesterol exposure burden ( OR=1.270, 95% CI: 1.071-1.507), and high-remnant cholesterol exposure duration (6 years: OR=1.351, 95% CI: 1.077-1.695) were significantly associated with the risk of developing a poor baPWV progression trajectory. These results remained significant after adjusting for cumulative average LDL-C levels. The association between baseline remnant cholesterol levels and baPWV progression became insignificant after adjusting for cumulative remnant cholesterol levels ( OR=1.053, 95% CI: 0.923-1.197), while the association between cumulative remnant cholesterol exposure and baPWV progression remained significant after adjusting for baseline remnant cholesterol levels ( OR=1.145, 95% CI: 1.008-1.305). Conclusions:Higher levels of baseline remnant cholesterol and cumulative remnant cholesterol are independent risk factors for the progression of arterial stiffness. These associations remain significant even after adjusting for traditional cardiovascular risk factors and LDL-C levels. Furthermore, the effect of cumulative remnant cholesterol levels on the progression of arterial stiffness was stronger than the effect of baseline remnant cholesterol levels.

Objective By analyzing the anti-tumor innovative drug policies text in China,this study aimed to explore the focus and shortcomings of policies related to anti-tumor innovative drugs,and provide the reference for future policy formula-tion and optimization in the field of anti-tumor innovative drug.Methods By accessing the official websites of relevant minis-tries and subordinate institutions such as the Central Committee of the Communist Party of China,the State Council of the People's Republic of China,the National Health Commission of the People's Republic of China,and National Medical Products Administra-tion,and using the keywords"cancer","tumor","anti-tumor drug",and"innovative drug",etc,the national level policies related to the anti-tumor innovative drugs from January 1,2005,to December 31,2022,were collected.Based on a two-dimensional analy-sis framework of policy tools and stakeholders,the collected policy texts were classified,encoded,and statistically analyzed.Results A total of 30 policy texts were involved,and a total of 90 policy codes were generated.There were 24,43,and 23 codes for demand-based policy tools,environmental policy tools,and supply-based policy tools,accounting for 26.67%,47.78%,and 25.56%,respectively.Based on policy tools and stakeholders,a total of 183 codes were generated,with government departments,pharmaceutical enterprises,medical institutions,and patients having 70,36,54,and 23 codes respectively,accounting for 38.25%,19.67%,29.51%,and 12.57%.Conclusions China had the highest proportion of environmental policy tools in the application of innovative anti-tumor drug policies,while supply-oriented and demand-oriented policy tools were underutilized,resulting in an overall imbalance in application;The distribution pattern of stakeholders was not coordinated,with government departments and medical institutions having higher attention than pharmaceutical enterprises and patients..It was necessary to reasonably promote the collaborative application of anti-tumor innovative drug policy tools,scientifically plan the layout of anti-tumor innovative drug policy sub-tools,and balance the interests of all stakeholders to ensure the efficient implementation of the policies.

Objective:To investigate the incidence and prothrombotic risk factors of postoperative venous thromboembolism(VTE) in Cushing′s disease and to further develop an assessment model to identify those at high risk of postoperative VTE events.Methods:A retrospective study was performed in 82 patients who were admitted to Huashan Hospital, Fudan University during January 2019 and January 2020 and diagnosed with Cushing′s disease. These patients underwent the evaluation about their clinical, hormonal, and coagulation parameters, as well as ultrasonography and pulmonary angio-CT when necessary. The least absolute shrinkage and selection operator(LASSO) regression analysis was used to screen independent risk factors, and a nomogram model for postsurgical VTE risk assessment in Cushing′s disease was initially established, and Bootstrap method was used for internal verification. Finally, the predictive model was evaluated for calibration and clinical applicability in the study cohort.Results:Nineteen patients(23.17%) developed VTE events, with 14 cases occurring after endoscopic transsphenoidal surgery. Compared to patients without VTE, those in the VTE group were older( P<0.001), had longer postoperative bed rest, higher rates of current infection, higher HbA 1C levels, and more severe glucose tolerance impairment(all P<0.05). Through LASSO regression analysis, two independent risk factors for postoperative VTE were identified: Age and current infection. Then a VTE risk assessment nomogram model was established to predict the patients at high risk of VTE. In the nomogram model for VTE risk assessment, the area under the receiver operating characteristic curve was 0.868(95% CI 0.787-0.949), with the calibration curve closely aligning with the ideal diagonal line and the clinical decision curve exceeding the two extreme curves. Conclusions:Advanced perioperative assessment needs to be taken to screen those with high VTE risks in patients diagnosed with Cushing′s disease. Additionally, during the perioperative period, patients with Cushing′s disease should undergo mandatory physical activity or prophylactic anticoagulant therapy.

Objective To investigate the roles of histone H3K27me3 methylation and its regulatory enzymes JMJD3 and EZH2 in the differentiation of Th17 cells in ankylosing spondylitis(AS),to unveil their potential involvement in the pathogenesis of AS,and to provide new strategies and targets for the clinical treatment of AS by analyzing the methylation state of H3K27me3 and its interactions with Th17-related factors.Methods A total of 84 AS patients(42 active AS patiens and 42 patients in the stable phase of AS)were enrolled for the study,while 84 healthy volunteers were enrolled as the controls.Blood samples were collected.Peripheral blood mononuclear cells were isolated.ELISA assay was performed to examine Th17 cells and the relevant cytokines IL-21,IL-22,and IL-17.The mRNA expressions of RORc,JAK2,and STAT3 were analyzed by RT-PCR,the protein expressions of RORc,JAK2/STAT3 pathway protein,H3K27me3 and the relevant protease(EZH2 and JMJD3)were determined by Western blot.Correlation between H3K27me3,EZH2 and JMJD3 and the key signaling pathway molecules of Th cell differentiation was analyzed by Pearson correlation analysis.Results The mRNA expressions of RORc,JAK2,and STAT3 were significantly higher in the active phase group than those in the stable phase group(P<0.05).The relative grayscale values of H3K27me3 and EZH2 in the active phase group were lower than those of the stable phase group,which were lower than those of the control group,with the differences being statistically significant(P<0.05).The relative grayscale values of JMJD3,RORc,JAK2,pJAK2,STAT3,and pSTAT3 proteins were significantly higher in the active phase group than those in the stable phase group,which were higher than those in the control group(all P<0.05).The proportion of Th17 and the expression level of inflammatory factors in the active period group were higher than those in the other two groups(P<0.05).H3K27me3 was negatively correlated with RORc,JAK2,STAT3,and IL-17,JMJD3 was positvely correlated with JAK2,STAT3,and IL-17,and EZH2 was negatively correlated with JAK2,STAT3,and IL-17(all P<0.05).Conclusion The low expression of H3K27me3 in AS is influenced by the gene loci JMJD3 and EZH2,which can regulate the differentiation of Th17 cells and thus play a role in the pathogenesis and progression of AS.