Objective To study the distribution and drug resistance characteristics of pathogenic bacteria in the elderly population of China by collecting and analyzing the standardized case data on the pathogens of infections in elderly patients,and to facilitate the establishment of a standardized layered surveillance system for pathogenic bacteria in China.Methods We collected the case data of elderly patients(≥65 years old)from 62 sentinel hospitals across the country in 2021.Then,we statistically analyzed the data by patient age,their geographical region,the distribution of pathogenic bacteria,and the drug resistance characteristics of main pathogens.Results A total of 3468 cases from across the country were included in the study.The top three sources of patients were the intensive care unit(13.2%),the department of respiratory medicine(11.2%),and the department of general surgery(8.4%).The top three types of specimens were urine(25.5%),sputum(20.6%),and blood(18.7%).A total of 3468 strains of pathogens were isolated,among which,78.9%were gram-negative bacteria and 21.1%were gram-positive bacteria.The top five types of bacteria were Escherichia coli(20.9%),Klebsiella pneumoniae(18.3%),Pseudomonas aeruginosa(11.2%),Staphylococcus aureus(9.0%),and Acinetobacter baumannii(7.0%).The isolation rates of common important drug-resistant bacteria were 38.0%for methicillin-resistant Staphylococcus aureus(MRSA),68.7%for carbapenem-resistant Acinetobacter baumannii(CRAB),and 38.2%for carbapenem-resistant Pseudomonas aeruginosa(CRPA),20.1%for carbapenem-resistant Klebsiella pneumoniae(CRKP),5.2%for carbapenem-resistant Escherichia coli(CRECO),and 2.1%for vancomycin-resistant Enterococcus(VRE).There were differences in the isolation rates of CRAB and CRKP in clinical care in the elderly population in seven geographical regions of China(P＜0.05).Klebsiella pneumoniae is the most important pathogen in the elderly population≥85 years old,and the isolation rates of CRKP showed significant differences in different age groups(P＜0.05).Conclusion There are significant differences in the drug resistance of pathogenic bacteria in the elderly populations of different regions and age groups in China.Therefore,monitoring the distribution and drug resistance of pathogenic bacteria in the elderly population and formulating targeted treatment plans according to the characteristics of the specific regions and age groups are of great significance to the improvement in the treatment outcomes and prognosis of the elderly population.

OBJECTIVE: To investigate the feasibility and effectiveness of absorbable anchor combined with Kirschner wire fixation in the reconstruction of extension function of old mallet finger. METHODS: Between January 2020 and January 2022, 23 cases of old mallet fingers were treated. There were 17 males and 6 females with an average age of 42 years (range, 18-70 years). The cause of injury included sports impact injury in 12 cases, sprain in 9 cases, and previous cut injury in 2 cases. The affected finger included index finger in 4 cases, middle finger in 5 cases, ring finger in 9 cases, and little finger in 5 cases. There were 18 patients of tendinous mallet fingers (Doyle type Ⅰ), 5 patients were only small bone fragments avulsion (Wehbe type ⅠA). The time from injury to operation was 45-120 days, with an average of 67 days. The patients were treated with Kirschner wire to fix the distal interphalangeal joint in a mild back extension position after joint release. The insertion of extensor tendon was reconstructed and fixed with absorbable anchors. After 6 weeks, the Kirschner wire was removed, and the patients started joint flexion and extension training. RESULTS: The postoperative follow-up ranged from 4 to 24 months (mean, 9 months). The wounds healed by first intention without complications such as skin necrosis, wound infection, and nail deformity. The distal interphalangeal joint was not stiff, the joint space was good, and there was no complication such as pain and osteoarthritis. At last follow-up, according to Crawford function evaluation standard, 12 cases were excellent, 9 cases were good, 2 cases were fair, and the good and excellent rate was 91.3%. CONCLUSION Absorbable anchor combined with Kirschner wire fixation can be used to reconstruct the extension function of old mallet finger, which has the advantages of simple operation and less complications.
Male ; Female ; Humans ; Adult ; Bone Wires ; Fracture Fixation, Internal ; Finger Injuries/surgery* ; Fractures, Bone/surgery* ; Tendon Injuries/surgery* ; Fingers ; Treatment Outcome ; Finger Joint/surgery*

Colorectal cancer (CRC), a malignant tumor worldwide consists of microsatellite instability (MSI) and stable (MSS) phenotypes. Although SHP2 is a hopeful target for cancer therapy, its relationship with innate immunosuppression remains elusive. To address that, single-cell RNA sequencing was performed to explore the role of SHP2 in all cell types of tumor microenvironment (TME) from murine MC38 xenografts. Intratumoral cells were found to be functionally heterogeneous and responded significantly to SHP099, a SHP2 allosteric inhibitor. The malignant evolution of tumor cells was remarkably arrested by SHP099. Mechanistically, STING-TBK1-IRF3-mediated type I interferon signaling was highly activated by SHP099 in infiltrated myeloid cells. Notably, CRC patients with MSS phenotype exhibited greater macrophage infiltration and more potent SHP2 phosphorylation in CD68⁺ macrophages than MSI-high phenotypes, suggesting the potential role of macrophagic SHP2 in TME. Collectively, our data reveals a mechanism of innate immunosuppression mediated by SHP2, suggesting that SHP2 is a promising target for colon cancer immunotherapy.

Atrial fibrillation (AF) is one of the most common arrhythmias, associated with high morbidity, mortality, and healthcare costs, and it places a significant burden on both individuals and society. Anti-arrhythmic drugs are the most commonly used strategy for treating AF. However, drug therapy faces challenges because of its limited efficacy and potential side effects. Catheter ablation is widely used as an alternative treatment for AF. Nevertheless, because the mechanism of AF is not fully understood, the recurrence rate after ablation remains high. In addition, the outcomes of ablation can vary significantly between medical institutions and patients, especially for persistent AF. Therefore, the issue of which ablation strategy is optimal is still far from settled. Computational modeling has the advantages of repeatable operation, low cost, freedom from risk, and complete control, and is a useful tool for not only predicting the results of different ablation strategies on the same model but also finding optimal personalized ablation targets for clinical reference and even guidance. This review summarizes three-dimensional computational modeling simulations of catheter ablation for AF, from the early-stage attempts such as Maze III or circumferential pulmonary vein isolation to the latest advances based on personalized substrate-guided ablation. Finally, we summarize current developments and challenges and provide our perspectives and suggestions for future directions.

Objective:To analyze the relationship between DNA methyltransferase 1 (DNMT1) and forkhead box O3a (FOXO3a) in colon cancer and the diagnostic efficacy of combined detection in predicting the occurrence of colon cancer by detecting the levels of DNMT1 and FOXO3a in serum of colon cancer patients.Methods:A total of 105 patients with colon cancer diagnosed and treated in Xi′an International Medical Center Hospital from September 2019 to September 2020 were selected as the colon cancer group, and 65 patients with colon polyps diagnosed by biopsy during the same period were selected as control group. The levels of DNMT1 and FOXO3a in serum of patients were detected by real-time fluorescence quantitative PCR. Pearson correlation coefficient method was used to analyze the correlation between the levels of DNMT1 and FOXO3a in serum of patients with colon cancer. Subject operating characteristic curve was used to evaluate the diagnostic values of DNMT1 and FOXO3a levels in colon cancer.Results:The serum levels of DNMT1 in the control group and colon cancer group were 0.93±0.28 and 1.34±0.35, compared with the control group, the level of DNMT1 in the colon cancer group was significantly higher, with a statistically significant difference ( t=7.990, P<0.001). The serum levels of FOXO3a were 1.04±0.39 and 0.69±0.18, compared with the control group, the level of FOXO3a in the colon cancer group was significantly lower, with a statistically significant difference ( t=7.940, P=0.001). The serum levels of DNMT1 and FOXO3a in patients with colon cancer were negatively correlated ( r=-0.687, P<0.001). The area under the curve (AUC) of DNMT1 predicting colon cancer was 0.843, the sensitivity was 71.40%, and the specificity was 90.80%. The AUC of FOXO3a predicting colon cancer was 0.812, the sensitivity was 88.60%, and the specificity was 67.70%. The AUC of the two combined predicting colon cancer was 0.859, the sensitivity was 89.50%, and the specificity was 92.30%. Compared with FOXO3a single detection, the predictive value of combined detection of DNMT1 and FOXO3a were higher ( Z=1.982, P=0.047). Conclusion:The level of DNMT1 in the serum of patients with colon cancer is increased, while the level of FOXO3a is decreased. There is a negative correlation between them in the serum of patients with colon cancer. The combined detection of the DNMT1 and FOXO3a can effectively improve the diagnostic value of colon cancer.

Objective    To explore the predictive value of myocardial vitality in the improvement of cardiac function after coronary artery bypass grafting (CABG) in patients with ischemic heart failure. Methods    From December 8, 2015 to November 12, 2018, 46 patients with ischemic heart failure who underwent CABG operation alone were collected retrospectively. There were 41 males and 5 females with an average age of 60.4±8.0 years. The myocardial vitality and number of different types of myocardium were measured. The clinical data of patients in the left ventricular ejection fraction (LVEF) improvement group (≥5%) and non-improvement group (<5%) were compared and analyzed. The  correlation between each index and LVEF improvement was analyzed by logistic multivariate regression analysis, and the boundary value of hibernating myocardium between LVEF improvement and non-improvement was obtained by receiver operating characteristic (ROC) curve. Results    There were significant differences in the number of hibernating myocardium (15.0%±12.3% vs. 4.3%±4.5%, P=0.000), the number of normal myocardium (74.7%±13.7% vs. 82.4%±8.6%, P=0.027), and cardiac function classification (NYHA) development (−0.7±0.7 vs. −0.3±0.5, P=0.047) between the two groups, but there was no significant difference in other indexes between the two groups (P>0.05). Logistic regression analysis showed that the number of hibernating myocardium was an independent factor affecting the improvement of LVEF after CABG in patients with ischemic heart failure (OR=1.366, 95%CI 1.033-1.807, P=0.029). The ROC curve showed that the threshold value, sensitivity and specificity of hibernating myocardium were 15.0%, 43.8% and 100.0%, respectively. Conclusion    The percentage of hibernating myocardium to left ventricular wall area ≥15.0% can accurately predict the improvement of LVEF in patients with ischemic heart failure after CABG. Preoperative myocardial vitality assessment has important diagnostic value in predicting the improvement of cardiac function in patients with ischemic heart failure after simple CABG.

Objective To investigate the molecular mechanism of P75NTR gene-induced apoptosis in tongue squamous cell carcinoma Tca8113 cell lineage.Methods P75NTR specific siRNA was transferred into P75NTR positive tongue squamous cell carcinoma Tca8113 cells.P75NTR positive Tca8113 cells were divided into 4 groups:blank group (without transfection),negative control group (transfected with negative control siRNA ), experiment group-776 (transfected with siRNA-P75NTR-776 ) and experiment group-1234 (transfected with siRNA-P75NTR-1234).Transfection efficiency and cell apoptosis were detected by flow cytometry.The interference effect of P75NTR mRNA expression was detected by fluorescence quantitative PCR. 3-(4,5-dimethyl-2-thiazoly)-2,5-diphenyl-2H-tetrazolium bromide assay was applied in measuring cell prolife-ration.The protein changes of P75NTR were detected by Western blotting.The distributions of nuclear factor-κB(NF-κB)of cells were observed by cell immunofluorescence labeling method.Results The transfection efficiency was 30%.The apoptosis rate of experiment group-776,experiment group-1234 and negative control group was (20.35 ±0.18)%,(12.32 ±1.51)% and (2.63 ±0.10)% respectively.Compared with the negative control group,the differences of the former two group had statistical significance (t =177.20,P <0.005;t =37.12,P <0.005).The P75NTR gene interference was successful.The inhibition rate of P75NTR protein reached 31% in experiment group-776.The cell viability of Tca8113 cells after P75NTR-siRNA inter-
ference was 70.02%,78.01% and 95.81% in experiment group-776,experiment group-1234 and negative control group.And there were significant differences between experiment group-776 and negative control group (χ2 =235.3,P <0.010),and between experiment group-1234 and negative control group (χ2 =117.5,P <0.005 ).NF-κB distribution was increased in cell cytoplasm in the interference group than that in control group.Conclusion P75NTR may promote the proliferation or inhibit the apoptosis of tongue squamous cell carcino-ma,and the molecular mechanism may be correlated with hindering the transportion of NF-κB into cell nuclear.

Aim To study the effects of Free Anthra-quinone from Rhubarb (FAR)on myocardial CTGF and collagen expression and interstitial fibrosis in dia-betic rats.Methods The male SD rats were randomly divided into normal group (CON),diabetic cardiomy-opathy group (DCM) and FAR treatment group (FAR).Streptozocin was intraperitoneally injected in-to the animals in the latter 2 groups to induce diabetic rat model.The model was expected to be stable for 2 weeks before the treatment.At the end of the 8th week in treatment,fasting plasma glucose and heart mass in-dex were measured.Masson staining was used to ob-serve the myocardial fibrosis.RT-PCR was used to de-tect the mRNA levels of CTGF,procollagen type Ⅰand collagen type Ⅲ.Immunohistochemical method was used to detect the content of CTGF.ELISA was used to detect the depositions of collagen type I and collagen type Ⅲ. Results Compared with CON group,fasting plasma glucose,heart mass index,the degree of myocardial fibrosis,and the expressions of CTGF,collagen type I and collagen type Ⅲ in left ven-tricular myocardial tissue of DCM group were signifi-cantly increased. However, compared with DCM group,fasting plasma glucose,heart mass index,the degree of myocardial fibrosis,and the expressions of CTGF,collagen type I and collagen type Ⅲ in left ven-tricular myocardial tissue of FAR-treated rats were sig-nificantly decreased.Conclusion FAR retards the process of myocardial fibrosis in diabetic rats by down-regulating the expression of CTGF,reducing the syn-thesis and depositions of collagen type I and collagen type Ⅲ.

Objective:To study the effect of p75NTR gene on the apoptosis of tongue squamous cell carcinoma Tca8113 cells. Methods:p75NTR +Tca8113 cells were isolated from Tca 8113 cell line and transfected by p75NTR siRNA using lipofectamine. p75NTR mRNA and protein expression was examined by real time RT-PCR and western blot respectively.Cell proliferation was stud-ied by MTT assay,cell apoptosis was examined by flow cytometry.Results:Proliferation of p75NTR + cells was faster than that of p75NTR - cells.Transfection of p75NTR siRNA inhibited p75NTR mRNA and protein expression in p75NTR + Tca8113 cells,inhibi-ted the proliferation and increased the apoptosis of the cells.Conclusion:p75NTR gene plays a role in the apoptosis of Tca8113 cells.

Objective To investigate effect of sitagliptin ( SIT) on the expression of inducible nitric oxide synthase ( iNOS) and nitric oxide ( NO) in type 2 diabetic nephropathy.Methods 30 rats were randomly divided into normal group (NC group), diabetic nephropathy group (DN group) and sitagliptin treatment group (SIT group).The type 2 diabetes mellitus (T2DM) rats were induced by a high fat diet (HFD) plus repeated low dose streptozocin (STZ) injections.At the end of the 12th week in treatment,there were 6 rats in each group, the NO level was determined by Griess method.mRNA levels of iNOS RT-PCR was detect ed by.The expression of iNOS protein was detected by western blot and immunohistochemical method. ResuIts Compared with the NC group, the expression of iNOS and NO of DN group increased significantly.However, compared with DN group, the expression of iNOS and NO of SIT group decreased significantly.ConcIusion SIT can decrease the expression of iNOS and NO, which implies SIT may protect the type 2 diabetic kidney.