The detection rate of carbapenem-resistant Enterobacter cloacae(CRECL)in clinical practice has risen steadily in recent years,and it has become one of the main pathogens of hospital-acquired infections.CRECL resistance is primarily driven by carbapenemase-encoding genes(CEG),which can spread through multiple mechanisms under the selective pressure of antibiotics and other environmental factors.This gene transfer significantly hampers antimicrobial treatment and infection control efforts.This review outlines the current understanding of CEG distribution in CRECL,key transmission pathways,and their public health im-plications.The findings aim to support the development of effective strategies for the prevention and manage-ment of CRECL infections.

Objective:To study the myocardial protective effects of exogenous supplement of nicotinamide adenine dinucleotide (NAD) in cardioplegic solution on rats undergoing extracorporeal circulation.Methods:Twenty-four SD rats were randomly divided into sham, model, and NAD 50, 200 mg/L groups, with 6 rats in each group, according to the random number table method. The rats in the sham group were only anesthetized and tracheally intubated, connected to a ventilator for respiratory support, and the extracorporeal circulation model was not established. Except the sham group, the model of extracorporeal circulation in rats was established by blocking the ascending aorta. The model group was then perfused with cardioplegic solution without NAD; the NAD 50 mg/L group was perfused with cardioplegic solution containing 50 mg/L NAD; and the NAD 200 mg/L group was perfused with cardioplegic solution containing 200 mg/L NAD. After five minutes of cardiac arrest, the aortic cross-clamp was removed to restore blood flow to the heart and allow the heart to gradually resume beating. Plasma and cardiac tissues were collected from each group of SD rats. The effects of NAD in cardioplegic solution on myocardial injury in the extracorporeal circulation model were examined by hematoxylin-eosin staining. The cross section area of cardiomyocytes was quantitatively analyzed by wheat germ agglutinin staining. The number of CD3-positive cells per unit cross section area was determined by immunohistochemical method. Levels of the inflammatory factor tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were measured by enzyme-linked immunosorbent assay. The relative mRNA expression of cysteine aspartic acid specific protease-3 ( Caspase-3), B-cell lymphoma-2 ( Bcl-2), Bcl-2 associated X protein ( Bax) and superoxide dismutase-2 ( SOD-2) was determined by real-time fluorescence quantitative PCR. Results:Compared with the model group, the cross section area of cardiomyocytes [(422.54±2.36) μm 2 vs (450.53±32.04) μm 2], the number of CD3-positive cells per unit cross section area [(150.49±34.17) cells/mm 2 vs (220.54±35.23) cells/mm 2], the expression levels of TNF-α [(69.37±8.82) pg/ml vs (76.08±9.02) pg/ml] and IL-6 [(130.72±15.54) pg/ml vs (144.19±11.98) pg/ml] were decreased in the NAD 50 mg/L group, and the mRNA expression levels of Bcl-2 (0.59±0.03 vs 0.46±0.07) and SOD-2 (0.62±0.06 vs 0.48±0.07) were increased in the NAD 50 mg/L group, however, the differences were not statistically significant (all P>0.05). The relative mRNA expression levels of Caspase-3 and Bax in the NAD 50 mg/L group were lower in the model group (2.23±0.32 vs 2.96±0.26, 2.42±0.08 vs 3.04±0.06) ( P<0.05, 0.01). Compared with the model group, the cross section area of cardiomyocytes [(383.35±8.12) μm 2], the number of CD3-positive cells per unit cross section area [(101.23±3.77) cells/mm 2], the expression levels of TNF-α and IL-6 [(51.70±4.64) pg/ml and (102.25±9.42) pg/ml], and the relative mRNA expression levels of Caspase-3 and Bax (1.41±0.09 and 1.45±0.07) were decreased ( P<0.05, 0.01). The relative mRNA expression levels of Bcl-2 (0.81±0.01) and SOD-2 (0.78±0.03) were increased (all P<0.01). Conclusions:Exogenous supplement of NAD in cardioplegic solution can effectively reduce circulating inflammatory cytohines and inhibit myocardial tissue apoptosis and myocardial injury.

Objective To explore root cause of poor prognosis after successful endovascular treatment(EVT)in patients with acute ischemic stroke with large vascular occlusion(AIS-LVO)of anterior circulation.Methods Patients with AIS-LOV of anterior circulation who received successful EVT(postoperative modified thrombolysis incerebral infarction[mTICI]grade≥2b)were retrospectively and continuously collected in the Department of Neurology of Bozhou People's Hospital from January 2022 to March 2024.The baseline and clinical data of the patients were collected,including gender,age,vascular risk factors(hypertension,diabetes,coronary heart disease,hyperlipidemia,valvular heart disease,atrial fibrillation,smoking,and alcohol consumption),prior stroke or transient ischemic attack,baseline blood pressure,baseline National Institutes of Health Stroke scale(NIHSS)score,laboratory test indicators(pre-operative C-reactive protein and D-dimer,post-operative fasting blood glucose,lipid levels,homocysteine,etc).Meanwhile,the data of perioperative indicators was collected,including the time from onset to admission,the time from admission to puncture,the time from puncture to revascularization,the time from onset to puncture,the time from onset to revascularization,remedial measures(balloon dilation,stent placement,arterial thrombolysis)during the surgery or not,using tirofiban or not,postoperative complications(stroke-related pneumonia,stress ulcers,deep vein thrombosis,acute heart failure or renal failure,etc)or not.The patient's medical history and imaging data were collected,and these indicators were defined and collected,including Alberta stroke program early CT score(ASPECTS),location of occlusion(C1 segment of the internal carotid artery,C2 segment to C7 segment of the internal carotid artery,M1 segment of the middle cerebral artery),and the trial of org 10172 in acute stroke treatment(TOAST)classification and a postoperative transformation of cerebral infarction after ischemic stroke and symptomatic intracranial hemorrhage or not.According to the modified Rankin scale(mRS)score at 90 d after surgery,all patients were divided into poor prognosis group(mRS score≥ 3)and good prognosis group(mRS score≤2).The baseline and clinical data of two groups were compared using univariate analysis.Variables with P＜0.1 in the univariate analysis were selected as independent variables,and the poor prognosis was used as the dependent variable.Further,multivariate Logistic regression analysis was performed to identify the influencing factors of poor prognosis after EVT.Results Finally,a total of 192 patients with AIS-LVO of anterior circulation who received successful revascularization were included in this study.There were 101 male patients and 91 female patients.The poor prognosis group had 102 cases and the good prognosis group had 90 cases.Univariate analysis showed that the poor prognosis group had statistically significant differences with the good prognosis group in terms of age(Z=-3.088,P=0.002)and age distribution(x2=13.457,P=0.001),fasting blood glucose(Z=-3.347,P=0.001),baseline NIHSS score(Z=-4.469,P＜0.01),location of occlusion(x2=10.488,P=0.005),transformation of hemorrhage after ischemic stroke(x2=16.943,P＜0.01),and symptomatic intracranial hemorrhage(X2=25.449,P＜0.01),and the baseline ASPECTS of the poor prognosis group was significantly lower than that of the good prognosis group(Z=-4.547,P＜0.01).There were no significant differences in other baseline and clinical data(all P＞0.05).Further multivariate Logistic regression analysis showed that age＞80 years(OR,3.224,95％CI 1.033-10.058,P=0.044),baseline NIHSS score(OR,1.102,95％CI 1.013-1.199,P=0.023),baseline ASPECTS(OR,0.375,95％CI 0.212-0.665,P=0.001),and symptomatic intracranial hemorrhage(OR,7.127,95％CI 1.296-39.203,P=0.024)were independent influencing factors of poor prognosis.Conclusion The independent factors of 90 d poor prognosis after successful EVT in patients with AIS-LVO of anterior circulation are age＞80 years,baseline NIHSS score,baseline ASPECTS,and symptomatic intracranial hemorrhage.

Objective:To explore the factors affecting changes of disc angle (ΔDA) during oblique lateral interbody fusion (OLIF) and establish a predictive model of ΔDA.Methods:This retrospective study included 119 patients with 174 segments undergoing OLIF procedures between July 2017 and August 2019 in Beijing Jishuitan Hospital. 45 males and 74 females with an average age of 62.1±9.8 years (33-86 years) were included. The lordotic cages were all 6 degrees. Radiographic parameters included preoperative and postoperative disc angle (DA), disc height (DH), ΔDA on flexion-extension views (ΔDA-FE), cage location and cage inclination. Pearson correlation coefficient and machine-learning techniques were utilized to identify factors related to ΔDA. Based on machine leaning techniques, ten-fold cross-validation for model training and validation were used to develop a predictive linear model for ΔDA.Results:The average ΔDA was 3.9°±4.8° with preoperative disc angle (preoperative DA) of 5.3°±5.0°. The average change of posterior DH (ΔPDH) was 3.1±2.1 mm with preoperative posterior DH of 6.6±1.9 mm. The average change of anterior DH was 6.1±3.2 mm. Pearson correlation analysis showed a significant negative correlation between ΔDA and preoperative DA ( r=-0.713, P<0.001), cage location ( r=-0.183, P=0.016), and ΔDA-FE ( r=-0.153, P=0.044). PDH changes were significantly negatively correlated with preoperative PDH ( r=-0.444, P<0.001) and positively correlated with cage location ( r=0.218, P=0.004). ΔDA was 10.8°±3.2° for negative preoperative DA (indicating kyphotic), 5.0°±3.7° for preoperative DA between 0° and 6°, and 1.0°±4.1° for preoperative DA>6°. A predictive model was developed using ten-fold cross-validation, resulting in the formula ΔDA=7.9°-0.8×preoperative DA ( R=0.707, MAE=2.837). Conclusion:Disc angle changes in OLIF primarily depend on the preoperative disc angle, secondly on cage location. The predicting model based on machine-learning techniques using preoperative disc angle facilitates preoperative planning for OLIF procedures.

Objective To compare the clinical outcomes between oblique lumbar interbody fusion(OLIF)and transforaminal lumbar interbody fusion(TLIF)for patients with degenerative spondylolisthesis during 2-year follow-ups.Methods Patients with symptomatic degenerative spondylolisthesis who underwent OLIF(46 cases)and TLIF(45 cases)between July 2017 and September 2020 with 2-year follow-ups were retrospectively reviewed.One level or two-level lumbar fusion were included.The primary outcomes were Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)at 2 years after surgery.The secondary outcomes included radiographic parameters,fusion rate,cage subsidence rate,and permanent nerve injury rate.Results No significantly different changes were noted in VAS-back[2(2,3)vs.2(2,2),P=0.943],VAS-leg[2(2,2)vs.2(2,2),P=0.988],and ODI[17％(10％,22％)vs.14％(10％,22％),P=0.417]between the OLIF group and the TLIF group,respectively.Greater restoration of disc height and segmental lordosis were obtained in the OLIF group[mean,(11.9±1.5)mm and 15.7°±7.2°]than in the TLIF group[mean,(9.2±2.0)mm and 12.5°±5.9°]at postoperative 2-year(P＜0.001 and P=0.029).The subsidence rate was lower in the OLIF group than in the TLIF group[19.6％(9/46)vs.40.0％(16/40),P=0.037].The fusion rates at postoperative 2-year were 93.5％(43/46)in the OLIF group and 87.5％(35/40)in the TLIF group,having no significant difference(P=0.562).The rates of permanent nerve injury were similar between the two groups[4.3％(2/46)vs.6.7％(3/45),P=0.980]at postoperative 2-year.Conclusion Short segment OLIF doesn't show better clinical outcomes and fusion rate than TLIF for degenerative spondylolisthesis,except for greater disc height restoration,greater segmental lordosis,and lower subsidence rate at postoperative 2-year.

Grooming,as an evolutionarily conserved repetitive behavior,is common in various animals,including humans,and serves essential functions including,but not limited to,hygiene maintenance,thermoregulation,de-arousal,stress reduction,and social behaviors.In rodents,grooming involves a patterned and sequenced structure,known as the syntactic chain with four phases that comprise repeated stereotyped movements happening in a cephalocaudal progression style,beginning from the nose to the face,to the head,and finally ending with body licking.The context-dependent occurrence of grooming behavior indicates its adaptive significance.This review briefly summarizes the neural substrates responsible for rodent grooming behavior and explores its relevance in rodent models of neuropsychiatric disorders and neurodegenerative diseases with aberrant grooming phenotypes.We further emphasize the utility of rodent grooming as a reliable measure of repetitive behavior in neuropsychiatric models,holding promise for translational psychiatry.Herein,we mainly focus on rodent self-grooming.Allogrooming(grooming being applied on one animal by its conspecifics via licking or carefully nibbling)and heterogrooming(a form of grooming behavior directing towards another animal,which occurs in other contexts,such as maternal,sexual,aggressive,or social behaviors)are not covered due to space constraints.

Objective:To explore the role of thioredoxin interaction protein (TXNIP)/NOD-like receptor protein 3 (NLRP3) pathway in renal interstitial fibrosis induced by renal ischemia-reperfusion injury (IRI) in mice.Methods:Adult male C57BL/6J mice aged 6 to 8 weeks and TXNIP knockout mice with the same genetic background were selected. The wild type mice were divided into the sham operation (Sham) group and renal IRI group. The TXNIP knockout mice were divided into the sham+TXNIP KO group and IRI+TXNIP KO group, with 12 mice in each group. The model of renal ischemia-reperfusion injury was established by clamping bilateral renal pedicles for 45 min and then restoring perfusion. The sham operation model was only dissociated bilateral renal arteries without other treatment. Blood creatinine, urea nitrogen, kidney injury molecule-1 (Kim-1) and neutrophil gelatinase-associated lipocalin (NGAL), blood transforming growth factor-β (TGF-β) and interleukin 6 (IL-6) were measured on the 1st, 7th and 28th days after reperfusion. The renal cortex was taken on the 1st and 28th days for Masson staining, in which the renal tubule-interstitial injury score was obtained. TGF-β and IL-6 mRNA expression were detected by qPCR, TXNIP, NLRP3, Pro-IL-1β, IL-1β and α-SMA protein expression were detected by Western blot, and MDA and SOD levels were detected by ELISA. Homogeneity test of variance was performed before the statistics of normal distribution measurement data, one-way ANOVA was used for the comparison between multiple groups, and LSD- t test was used for the comparison between the two groups. Results:On the 1st, 7th and 28th days after IRI, compared with the sham group, the Scr, BUN, Kim-1, NGAL, TGF-β and IL-6 were increased continuously in the IRI group ( P<0.05). On the 28th day after IRI, large areas of collagen fibers and inflammatory cell infiltration were observed in the renal interstitium of the IRI group. In the IRI group, the scores of renal tubular injury and renal interstitial fibrosis on the 28th day were significantly higher than those on the 1st day (all P<0.05). On the 1st, 7th and 28th days after IRI, compared with the IRI group, the levels of Scr, BUN, Kim-1, NGAL, TGF-β and IL-6 were significantly decreased in the IRI+TXNIP KO group (all P<0.05). On the 1st and 28th days after IRI, compared to the IRI group, the areas of collagen fibers and inflammatory cell infiltration in the renal interstitium of the IRI+TXNIP KO group were decreased. The renal tubule injury score [Day 1, (192.2 ± 62.4) vs. (103.2 ± 49.1); Day 28, (154.3 ± 93.6) vs. (64.3 ± 24.8), both P<0.05] and interstitial fibrosis score [Day 1, (7.3 ± 3.2) vs. (4.8 ± 1.7); Day 28, (12.8 ± 3.9) vs. (2.3 ± 0.8), both P<0.05] were all decreased. The expression of TGF-β, IL-6 mRNA, TXNIP, NLRP3, Pro-IL-1 β, IL-1 β and α-SMA protein in renal cortex were significantly decreased (both P<0.05). In renal cortex, MDA level was decreased and SOD level was increased (all P<0.05). Conclusions:TXNIP/NLRP3 pathway is involved in the development of renal interstitial inflammation and fibrosis after renal ischemia and reperfusion. Knockout or inhibition of TXNIP can inhibit the progression of acute renal injury to chronic renal disease.

Chlamydia trachomatis (CT) infection is the most prevalent sexually transmitted bacterial disease worldwide. However, unlike that in female infertility, the role of CT infection in male infertility remains controversial. The objective of this retrospective study was to explore the impacts of CT infection in the genital tract on sperm quality, sperm acrosin activity, antisperm antibody levels, and inflammation in a large cohort of infertile males in China. A total of 7154 semen samples were collected from infertile male subjects, 416 of whom were CT positive (CT+ group) and 6738 of whom were CT negative (CT- group), in our hospital between January 2016 and December 2018. Routine semen parameters (semen volume, pH, sperm concentration, viability, motility, morphology, etc.), granulocyte elastase levels, antisperm antibody levels, and sperm acrosin activity were compared between the CT+ and CT- groups. Our results showed that CT infection was significantly correlated with an abnormally low semen volume, as well as an increased white blood cell count and granulocyte elastase level (all P < 0.05) in the semen of infertile males; other routine semen parameters were not negatively impacted. The antisperm antibody level and sperm acrosin activity were not affected by CT infection. These findings suggested that CT infection might contribute to inflammation and hypospermia but does not impair sperm viability, motility morphology, and acrosin activity or generate antisperm antibodies in the infertile males of China.
Chlamydia trachomatis ; Female ; Genitalia ; Humans ; Infertility, Male/epidemiology* ; Inflammation/epidemiology* ; Male ; Retrospective Studies ; Semen ; Spermatozoa

Objective:To investigate the effect of carotid artery stenting (CAS) on cognitive function in patients with severe carotid artery stenosis.Methods:From January 2019 to December 2020, consecutive patients with severe carotid artery stenosis (stenosis degree ≥70%) treated in the Department of Neurology, Bozhou People's Hospital were selected. According to different treatment schemes, all patients were divided into a CAS group and a control group. The CAS group received CAS combined with the best drug treatment, while the control group only received the best drug treatment. The cognitive function was evaluated by Montreal Cognitive Assessment (MoCA) before treatment and at 6 months after treatment.Results:During the study, 52 patients with severe carotid artery stenosis were enrolled, including 37 patients in the CAS group and 15 in the control group. There were no significant differences in demographic and baseline clinical data between the two groups. All patients in the CAS group completed procedure successfully without any complications. MoCA score in the CAS group was significantly higher than that before treatment ( P<0.001), but not in the control group. There was no significant difference in MoCA score between the patients in the CAS group and the control group before treatment; the MoCA score in the CAS group was significantly higher than that in the control group at 6 months after treatment ( P=0.007). Conclusion:CAS may improve the short-term postoperative cognitive function of patients with severe carotid artery stenosis.

Objective:To evaluate the effect of oblique lateral interbody fusion (OLIF) combined with posterior fixation on segmental alignment in the treatment of degenerative spondylolisthesis (DS).Methods:The clinical data of 40 patients with DS who underwent OLIF combined with posterior fixation from July 2017 to December 2019 were retrospectively analyzed. There were 7 males and 33 females, aged 45-81 years, with an average age of 65.7±9.06 years. The total number of slip segments was 43, including 37 levels at L 4, 5, 5 levels at L 3, 4, and 1 level at L 2, 3. According to the decompression methods, the patients were divided into two groups. 22 patients with 23 levels were treated with direct decompression combined with laminectomy, and 18 patients with 20 levels were treated with indirect decompression without laminectomy. All patients underwent preoperative and intraoperative imaging examination. The disc height (DH), slip ratio (SR) and segmental lordosis (SL) were measured by preoperative CT and intraoperative fluoroscopy images. One-way repeated measures ANOVA was used to compare the radiographic parameters of the segmental alignment prior to cage implantation, following cage insertion and posterior fixation. Bonferroni test was used to compare the radiographic parameters between groups. Results:In the OLIF combined with the posterior fixation, there were statistically significant differences in the radiographic parameters of segmental alignment at different stages of operation [DH ( F=147.786, P<0.001) , SR ( F=83.754, P<0.001) , SL ( F=38.296, P<0.001) ]. DH increased from 7.99±1.39 mm to 11.69±1.72 mm ( P<0.001), SR decreased from 10.67%±4.67% to 8.66%±4.50% ( P=0.001) and SL increased from 7.26°±2.73° to 7.85°±2.30° ( P=0.425). After combined posterior fixation, SR further decreased from 8.66%±4.50% to 2.07%±4.00% ( P<0.001), SL further increased from 7.85°±2.30° to 10.72°±3.08° ( P<0.001), and DH had no significant change ( P=1.000). There was no significant difference in radiographic parameters between the direct decompression group and the indirect decompression group when prior to cage implantation, following cage insertion and following posterior fixation, respectively. Conclusion:OLIF combined with posterior fixation in the treatment of DS can further reduce the slip rate of patients with lumbar degenerative spondylolisthesis and increase the lordosis angle of the surgical segment. At the same time, the direct decompression combined with laminectomy has no significant effect on the segmental alignment.