OBJECTIVE To assess the current status of hospital-acquired infections and their economic burden in or-thopedic patients based on diagnosis-related groups(DRG).METHOD Based on the National Health Insurance dis-ease diagnosis-related groups,32 413 orthopedic patients from a tertiary care hospital in Beijing in 2021 were grouped,hospital-acquired infections were retrospectively analyzed,and the direct and indirect economic burdens of different DRG groups were assess using indictors such as hospitalization time and cost,bed turnover loss,and labor time loss.RESULTS A total of 32 413 patients were included,the incidence of hospital-acquired infection was 0.47％(153/32 413),the site of infection was predominantly the surgical site(57.99％),and hospital-acquired infections in the hematologic system had a greater impact on cost-consumption indices and time-consumption indi-ces.The infection cases were concentrated in 19.58％of the DRGs groups.The IF23 group(lower limb bone sur-gery with complications and comorbidities)had the highest direct economic burden(24 010 yuan/case)due to hos-pital-acquired infections,and the increase in the cost of consumables and medication was the main factor causing the direct economic burden.At both the hospital level and family-society level,the top three DRG groups in terms of indirect economic burden due to hospital-acquired infections were IB15,IB13 and IF23.CONCLUSION Hospital-acquired infections in orthopedic patients have a tendency to be concentrated,quantitatively assessment of their e-conomic burden based on DRGs not only illustrates the importance of hospital-acquired infection prevention and control,but also accurately identifies the disease groups that require focused management,providing an evidence-based basis for precise prevention and control of hospital-acquired infections.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective To investigate the short-term efficacy of the retrograde semi-retrieval technique(RESET)in the treatment of patients with acute intracranial large vessel occlusion.Methods This retrospective study involved 286 patients with acute intracranial large vessel occlusion who underwent mechanical thrombectomy using RESET at Tianjin Huanhu Hospital from November 2017 to March 2019.The patients were divided into two groups based on the presence or absence of intracranial atherosclerotic stenosis(ICAS):ICAS group(n=186,65％)and non-ICAS group(n=100,35％).Baseline characteristics,procedural outcomes,and 90-day modified Rankin Scale(mRS)scores were compared between the two groups.Results The two groups did not significantly differ in baseline characteristics,including age,gender,past medical history,on-admission National Institutes of Health Stroke Scale(NIHSS)score,and Alberta Stroke Program Early CT(ASPECT)score(all P＞0.05).Successful vascular recanalization was achieved in 272 patients(95.1％),with 209 patients(73.1％)achieving complete recanalization with a single thrombectomy attempt.Rescue therapy was required in 33 patients(11.5％).Two patients in the ICAS group died due to postoperative symptomatic intracranial hemorrhage,and one patient in the non-ICAS group died due to postoperative multiple organ failure.Compared with the non-ICAS group,the ICAS group had a significantly longer puncture-to-recanalization time[141.36(124.11,156.53)min vs.65.17(53.92,83.25)min,P＜0.001]but a significantly smaller number of thrombectomy attempts[1.00(1.00,1.00)vs.1.00(1.00,2.00),P=0.002].However,there were no significant differences between the two groups in terms of final recanalization rate,complete recanalization rate with a single thrombectomy attempt,distal embolism or embolization of new territory,symptomatic intracranial hemorrhage,perioperative death,or 90-day mRS score(all P＞0.05).Conclusion RESET demonstrates satisfactory short-term efficacy in the treatment of acute intracranial large vessel occlusion.The number of thrombectomy attempts required for complete recanalization is significantly lower in the ICAS group than in the non-ICAS group,suggesting that RESET is particularly suitable for patients with ICAS.

Objective:To explore the expression level of m6A methyltransferase ZC3H13 gene in primary acute myeloid leukemia(AML)and its relationship with clinical features and prognosis.Methods:A total of 131 newly diagnosed AML patients and 12 controls were enrolled from July 1,2018 to December 1,2021 in the Hematology Department of the Second Hospital of Shanxi Medical University.RT-qPCR technology was used to detect the expression level of ZC3H13 mRNA in bone marrow(BM)samples.A retrospective analysis was conducted to examine the correlation between ZC3H13 expression level and clinical indicators,gene mutations,and prognosis.Results:The expression level of ZC3H13 mRNA in primary AML patients was significantly higher than that in the control group(P＜0.001).The white blood cell count,proportion of BM blast cells,and relapse rate in the high ZC3H13 expression group were higher than those in the the low ZC3H13 expression group(all P＜0.05),while the Th/Ts ratio was lower(P＜0.01).Univariate survival analysis showed that patients with high expression of ZC3H13 had shorter median overall survival(OS)and disease-free survival(DFS)than those with low expression of ZC3H13(both P＜0.05).The results of multivariate Cox regression analysis showed that high-risk stratification(OS:HR=1.612,95％CI:1.151-2.257,P=0.005;DFS:HR=1.551,95％CI:1.031-2.335,P=0.035)and high ZC3H13 expression(OS:HR=1.756,95％CI:1.028-2.999,P=0.039;DFS:HR=1.935,95％CI:1.018-3.678,P=0.044)were both independent risk factors for OS and DFS in AML patients.Conclusion:The expression of ZC3H13 in AML patients may be related to tumor burden and immune function.Patients with high expression of ZC3H13 have poor prognosis,and high expression of ZC3H13 is an independent risk factor for the prognosis of AML patients.

Objective To construct a nomogram prediction model for predicting hemoglobin A1c(HbA1c)failure in type 2 diabetes mellitus(T2DM)patients.Methods A total of 936 inpatients with T2DM admitted to the Department of Endocrinology of the Affiliated Hospital of Shandong Second Medical University from January 2021 to January 2022 were selected as the research objects and divided into the non-standard group(HbA1c≥7%,n=801)and the standard group(HbA1c<7%,n=135).Univariate analysis was used to screen the related factors of HbA1c failure.Logistic regression multivariate model was used to analyze the influencing factors of HbA1c failure in T2DM patients.The R language was used to construct a nomogram,and the area under the receiver operating characteristic(ROC)curve(AUC)was used to evaluate the predictive ability of the model.The C-index and Hosmer-Lemeshow test were used to evaluate the discrimination and calibration of the model.Results There were statistically significant differences in triglyceride(TG),low-density lipoprotein cholesterol,direct bilirubin,urinary albumin/creatinine ratio(UACR),self-monitoring of blood glucose(SMBG),meat and vegetable pairing,hot pot,whole grain and animal viscera consumption between the two groups(P<0.05).Logistic regression analysis showed that TG(OR 1.699,95%CI 1.298～2.222),UACR(OR 1.003,95%CI 1.001～1.005),SMGB(OR 0.480,95%CI 0.313～0.735),more meat and less vegetables(OR 1.432,95%CI 1.062～1.931)were the influencing factors of HbA1c failure.The AUC of the nomogram prediction model based on the influencing factors was 0.711,with C-index 0.710(95%CI 0.663～0.758)and good calibration(χ2=11.185,P=0.191).Conclusions The nomogram prediction model for HbA1c failure in T2DM patients established based on TG,UACR,SMGB,meat and vegetarian mix has good discrimination and calibration,which can provide certain reference value for warning of poor blood glucose control.

Objective:To establish a method for the determination of 2-amino-5-chloro-N, 3-dimethylbenzamide in blood by ultra-performance liquid chromatography-quadrupole-orbitrap high resolution mass spectrometry (UPLC-Q-Orbitrap HRMS) .Methods:In October 2022, 200 μl of blood samples were taken and 800 μl of acetonitrile was added. The samples were centrifuged at 3500 r/min (with a centrifugation radius of 6.6 cm) for 15 minutes. The supernatant was detected in the positive ion target tandem mass spectrometry (Target MS 2) mode and quantified by the external standard method. Methodological validation was also carried out for the established method. Results:The working curve of 2-amino-5-chloro-N, 3-dimethylbenzamide showed good linearity in the concentration range of 2.07-165.44 μg/L, with a correlation coefficient ( r) of 0.9994. The intra-day and inter-day relative standard deviations ( RSD) for the detection of 2-amino-5-chloro-N, 3-dimethylbenzamide were 2.6%-3.0% and 3.1%-3.5%, respectively. Analytical accuracy of 2-amino-5-chloro-N, 3-dimethylbenzamide quantification ranged from 101.0 % to 108.4 %, and the limit of detection and limit of quantification were 0.11 μg/L and 0.36 μg/L, respectively. The blood samples were able to be stored at -20 ℃ for at least 7 days. Conclusion:The UPLC-Q-Orbitrap HRMS determination method is sensitive, efficient and accurate, and can be used for the determination of 2-amino-5-chloro-N, 3-dimethylbenzamide in blood.

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

Objective To construct a nomogram prediction model for predicting hemoglobin A1c(HbA1c)failure in type 2 diabetes mellitus(T2DM)patients.Methods A total of 936 inpatients with T2DM admitted to the Department of Endocrinology of the Affiliated Hospital of Shandong Second Medical University from January 2021 to January 2022 were selected as the research objects and divided into the non-standard group(HbA1c≥7%,n=801)and the standard group(HbA1c<7%,n=135).Univariate analysis was used to screen the related factors of HbA1c failure.Logistic regression multivariate model was used to analyze the influencing factors of HbA1c failure in T2DM patients.The R language was used to construct a nomogram,and the area under the receiver operating characteristic(ROC)curve(AUC)was used to evaluate the predictive ability of the model.The C-index and Hosmer-Lemeshow test were used to evaluate the discrimination and calibration of the model.Results There were statistically significant differences in triglyceride(TG),low-density lipoprotein cholesterol,direct bilirubin,urinary albumin/creatinine ratio(UACR),self-monitoring of blood glucose(SMBG),meat and vegetable pairing,hot pot,whole grain and animal viscera consumption between the two groups(P<0.05).Logistic regression analysis showed that TG(OR 1.699,95%CI 1.298～2.222),UACR(OR 1.003,95%CI 1.001～1.005),SMGB(OR 0.480,95%CI 0.313～0.735),more meat and less vegetables(OR 1.432,95%CI 1.062～1.931)were the influencing factors of HbA1c failure.The AUC of the nomogram prediction model based on the influencing factors was 0.711,with C-index 0.710(95%CI 0.663～0.758)and good calibration(χ2=11.185,P=0.191).Conclusions The nomogram prediction model for HbA1c failure in T2DM patients established based on TG,UACR,SMGB,meat and vegetarian mix has good discrimination and calibration,which can provide certain reference value for warning of poor blood glucose control.

Objective To investigate the short-term efficacy of the retrograde semi-retrieval technique(RESET)in the treatment of patients with acute intracranial large vessel occlusion.Methods This retrospective study involved 286 patients with acute intracranial large vessel occlusion who underwent mechanical thrombectomy using RESET at Tianjin Huanhu Hospital from November 2017 to March 2019.The patients were divided into two groups based on the presence or absence of intracranial atherosclerotic stenosis(ICAS):ICAS group(n=186,65％)and non-ICAS group(n=100,35％).Baseline characteristics,procedural outcomes,and 90-day modified Rankin Scale(mRS)scores were compared between the two groups.Results The two groups did not significantly differ in baseline characteristics,including age,gender,past medical history,on-admission National Institutes of Health Stroke Scale(NIHSS)score,and Alberta Stroke Program Early CT(ASPECT)score(all P＞0.05).Successful vascular recanalization was achieved in 272 patients(95.1％),with 209 patients(73.1％)achieving complete recanalization with a single thrombectomy attempt.Rescue therapy was required in 33 patients(11.5％).Two patients in the ICAS group died due to postoperative symptomatic intracranial hemorrhage,and one patient in the non-ICAS group died due to postoperative multiple organ failure.Compared with the non-ICAS group,the ICAS group had a significantly longer puncture-to-recanalization time[141.36(124.11,156.53)min vs.65.17(53.92,83.25)min,P＜0.001]but a significantly smaller number of thrombectomy attempts[1.00(1.00,1.00)vs.1.00(1.00,2.00),P=0.002].However,there were no significant differences between the two groups in terms of final recanalization rate,complete recanalization rate with a single thrombectomy attempt,distal embolism or embolization of new territory,symptomatic intracranial hemorrhage,perioperative death,or 90-day mRS score(all P＞0.05).Conclusion RESET demonstrates satisfactory short-term efficacy in the treatment of acute intracranial large vessel occlusion.The number of thrombectomy attempts required for complete recanalization is significantly lower in the ICAS group than in the non-ICAS group,suggesting that RESET is particularly suitable for patients with ICAS.

Objective To analyze the disease burden of chronic kidney diseases (CKD) attributed to high body mass index (BMI) in China from 1992 to 2021 and predict the disease burden for the next decade, and to provide evidence for the prevention and treatment of CKD. Methods Using the Global Burden of Disease (GBD) database and the Joinpoint model, the average annual percentage rate change (AAPC) of the mortality rate and disability-adjusted life year (DALY) rate was calculated to describe and analyze the CKD disease burden attributed to high BMI in China from 1992 to 2021. The ARIMA model was employed to predict and analyze the change trend of the CKD disease burden. Results From 1992 to 2021, the mortality rate and DALY rate attributed to high BMI-induced chronic kidney disease showed an upward trend. Compared to 1992, the attributed number of deaths increased by 324.38%, and DALYs increased by 268.56%; the mortality rate increased by 64.00%, and the DALY rate grew by 51.62%. From 1992 to 2021, the mortality rate and DALY rate for males were lower than those for females, but the growth rate for males exceeded that of females. From 1992 to 2021, the mortality rate and DALY rate of chronic kidney disease attributed to high BMI in China increased with age. The average annual change rate of chronic kidney disease attributed to high BMI in China from 1992 to 2021 (mortality rate: 1.40 per 100,000 (95% CI: 1.04–1.76), DALY rate: 1.43 per 100 000 (95% CI: 1.17–1.70)) was higher than thHuaiyin Normal University, Huai'anher social demographic index (SDI) regions. The ARIMA model predicted that the age-standardized mortality rate increased from 2.91 per 100 000 in 2022 to 3.05 per 100 000 in 2026, and the age-standardized DALY rate increased from 69.65 per 100 000 in 2022 to 73.58 per 100 000 in 2026. Conclusion Chronic kidney disease attributed to high BMI in China is on the rise, and it will continue to grow in the future. The focus of CKD prevention and control should be on males and the elderly, while active measures should be taken to reduce the occurrence and progression of chronic kidney disease.