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 changes of nitric oxide(NO),endothelin-1(ET-1),thromboxane B2(TXB2)levels in patients with chronic heart failure(CHF)and their correlation with plasma brain natriuretic peptide(BNP).Methods:We enrolled 110 CHF patients admitted in the Second Hospital of Qinhuangdao between January and December 2022.According to the New York Heart Association(NYHA)cardiac function classification,the patients were divided into cardiac function class Ⅱ group(n=22),cardiac function class Ⅲ group(n=50),and cardiac function class Ⅳ group(n=38).Baseline data,levels of NO,ET-1,TXB2,BNP and other related laboratory indexes were compared among three groups.Pearson correlation analysis was used to analyze the association of NO,ET-1,TXB2 with plasma BNP in CHF patients.Multivariate linear regression was employed to analyze related factors of elevated BNP in CHF patients.Results:Compared with patients in class Ⅱ group and class Ⅲ group,those in class Ⅳ group had significant higher uric acid[(467.39±32.60)μmol/L vs.(367.25±22.39)μmol/L vs.(421.42±28.34)μmol/L],total bilirubin[(17.36±3.10)μmol/L vs.(10.65±1.39)μmol/L vs.(11.12±2.01)μmol/L],BNP[(897.60±50.11)ng/L vs.(381.37±31.25)ng/L vs.(527.60±47.84)ng/L],NO[(50.12±5.95)μmol/L vs.(25.36±2.14)μmol/L vs.(37.92±4.84)μmol/L],ET-1[(114.10±10.53)pg/L vs.(80.25±7.38)pg/L vs.(97.03±8.40)pg/L],TXB2[(417.98±29.35)pg/ml vs.(302.63±19.63)pg/ml vs.(381.29±26.44)pg/ml](P＜0.001 all).Compared with those in class Ⅱ group,those in class Ⅲ group had significant higher above-mentioned indexes(except total bilirubin)(P＜0.001 all).Pearson correlation analysis indicated that plasma NO,ET-1,TXB2 were positively associated with BNP(r=0.828,0.750,0.720,P＜0.001 all).Multivariate linear regression analysis indicated that uric acid,total bilirubin,plasma NO,ET-1 and TXB2 levels were independent risk factors for elevated BNP level in CHF patients(B=0.555～20.550,P＜0.05 or＜0.01),while the use of angiotensin converting enzyme inhibitors(ACEI)/angiotensin Ⅱ receptor blockers(ARB)was an independent protective factor(B=-46.222,P=0.027).Conclusion:The levels of NO,ET-1,and TXB2 are closely related to the occurrence and development of CHF,and they show an increasing trend with the progression of CHF,and is closely related to BNP.

Objective:To investigate the changes of nitric oxide(NO),endothelin-1(ET-1),thromboxane B2(TXB2)levels in patients with chronic heart failure(CHF)and their correlation with plasma brain natriuretic peptide(BNP).Methods:We enrolled 110 CHF patients admitted in the Second Hospital of Qinhuangdao between January and December 2022.According to the New York Heart Association(NYHA)cardiac function classification,the patients were divided into cardiac function class Ⅱ group(n=22),cardiac function class Ⅲ group(n=50),and cardiac function class Ⅳ group(n=38).Baseline data,levels of NO,ET-1,TXB2,BNP and other related laboratory indexes were compared among three groups.Pearson correlation analysis was used to analyze the association of NO,ET-1,TXB2 with plasma BNP in CHF patients.Multivariate linear regression was employed to analyze related factors of elevated BNP in CHF patients.Results:Compared with patients in class Ⅱ group and class Ⅲ group,those in class Ⅳ group had significant higher uric acid[(467.39±32.60)μmol/L vs.(367.25±22.39)μmol/L vs.(421.42±28.34)μmol/L],total bilirubin[(17.36±3.10)μmol/L vs.(10.65±1.39)μmol/L vs.(11.12±2.01)μmol/L],BNP[(897.60±50.11)ng/L vs.(381.37±31.25)ng/L vs.(527.60±47.84)ng/L],NO[(50.12±5.95)μmol/L vs.(25.36±2.14)μmol/L vs.(37.92±4.84)μmol/L],ET-1[(114.10±10.53)pg/L vs.(80.25±7.38)pg/L vs.(97.03±8.40)pg/L],TXB2[(417.98±29.35)pg/ml vs.(302.63±19.63)pg/ml vs.(381.29±26.44)pg/ml](P＜0.001 all).Compared with those in class Ⅱ group,those in class Ⅲ group had significant higher above-mentioned indexes(except total bilirubin)(P＜0.001 all).Pearson correlation analysis indicated that plasma NO,ET-1,TXB2 were positively associated with BNP(r=0.828,0.750,0.720,P＜0.001 all).Multivariate linear regression analysis indicated that uric acid,total bilirubin,plasma NO,ET-1 and TXB2 levels were independent risk factors for elevated BNP level in CHF patients(B=0.555～20.550,P＜0.05 or＜0.01),while the use of angiotensin converting enzyme inhibitors(ACEI)/angiotensin Ⅱ receptor blockers(ARB)was an independent protective factor(B=-46.222,P=0.027).Conclusion:The levels of NO,ET-1,and TXB2 are closely related to the occurrence and development of CHF,and they show an increasing trend with the progression of CHF,and is closely related to BNP.

Objective:To explore the correlation among sensory information processing, self-regulation abilities, and clinical symptoms in children with autism spectrum disorder (ASD).Methods:From December 1, 2023 to May 1, 2024, a total of 73 ASD children aged 3-7 years old meeting the inclusion criteria were recruited, and they were divided into mild group ( n=20), moderate group ( n=26), and severe group ( n=27) based on clinical symptoms.The sensory processing and self-regulation checklist (SPSRC) was used to assess sensory processing and self-regulation abilities. Clinical symptoms of ASD were assessed by the social responsiveness scale (SRS), the autism behavior checklist (ABC), and the childhood autism rating scale (CARS). Statistical analysis was conducted by SPSS 25.0 software, including Chi-square test, one-way ANOVA, and Pearson correlation analysis. Results:Abnormal rates of sensory processing across the six domains in ASD children were as follows: auditory (31.51%, 23/73), visual (32.88%, 24/73), tactile (32.88%, 24/73), gustatory/olfactory (32.88%, 24/73), vestibular (24.66%, 18/73), and proprioception (27.40%, 20/73).Abnormal rates of self-regulation abilities across the three domains were as follows: physiological state (38.36%, 28/73), emotional regulation (49.32%, 36/73), and adaptability (31.51%, 23/73).The severe group showed higher abnormal rates in SPSRC domains compared to the moderate and mild groups (all P<0.05). Total scores of each SPSRC domain were negatively correlated with total scores of SRS, ABC, and CARS ( r=-0.648--0.236, all P<0.05). Conclusion:The more severe the impairment in sensory processing and self-regulation abilities in ASD children, the more severe their clinical symptoms. Improving sensory processing and self-regulation abilities may contribute to the rehabilitation of children with ASD.

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.

The field(emergency)rapid inspection systems involving in the backpack,chest,vehicle and shelter had their research advances introduced and characteristics and deficiencies analyzed,and some improvement suggestions were put forward accordingly.It's pointed out the backpack,chest,vehicle and shelter be combined effectively to enhance the mobility and flexibility of field(emergency)rapid inspection systems.References were provided for the future enhancement and effecient operation of field(emergency)rapid inspection systems.[Chinese Medical Equipment Journal,2025,46(2):80-86]

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.

Disruption of the intestinal mucosal barrier caused by gut dysbiosis and metabolic imbalance is the underlying pathology of inflammatory bowel disease (IBD). Traditional Chinese medicine Wuji Wan (WJW) is commonly used to treat digestive system disorders and showed therapeutic potential for IBD. In this interdisciplinary study, we aim to investigate the pharmacological effects of WJW against experimental colitis by combining functional metabolomics and gut-microbiota sequencing techniques. Treatment with WJW altered the profile of the intestinal microbiota and notably increased the abundance of Lactobacillus, thereby facilitating the conversion of tryptophan into indole-3-acetic acid (IAA) and indoleacrylic acid (IA). These indole derivatives activated the aryl hydrocarbon receptor (AhR) pathway, which reduced colonic inflammation and restored the expression of intestinal barrier proteins. Interestingly, the beneficial effects of WJW on gut barrier function improvement and tryptophan metabolism were disappeared in the absence of gut microbiota. Finally, pre-treatment with the AhR antagonist CH-223191 confirmed the essential role of IAA-mediated AhR activation in the therapeutic effects of WJW. Overall, WJW enhanced intestinal barrier function and reduced colonic inflammation in a murine colitis model by modulating Lactobacillus-IAA-AhR signaling pathway. This study provides novel insights into colitis pathogenesis and presents an effective therapeutic and preventive approach against IBD.

Background: Maturity-onset diabetes of the young (MODY) due to variants of hepatocyte nuclear factor 1-beta (HNF1β) (MODY5) has not been well studied in the Chinese population. This study aimed to estimate its prevalence and evaluate the application of a clinical screening method (Faguer score) in Chinese early-onset diabetes (EOD) patients. Methods: Among 679 EOD patients clinically diagnosed with type 2 diabetes mellitus (age at diagnosis ≤40 years), the exons of HNF1β were sequenced. Functional impact of rare variants was evaluated using a dual-luciferase reporter system. Faguer scores ≥8 prompted multiplex ligation-dependent probe amplification (MLPA) for large deletions. Pathogenicity of HNF1β variants was assessed following the American College of Medical Genetics and Genomics (ACMG) guidelines. Results: Two rare HNF1β missense mutations (E105K and G454R) were identified by sequencing in five patients, showing functional impact in vitro. Another patient was found to have a whole-gene deletion by MLPA in 22 patients with the Faguer score above 8. Following ACMG guidelines, six patients carrying pathogenic or likely pathogenic variant were diagnosed with MODY5. The estimated prevalence of MODY5 in Chinese EOD patients was approximately 0.9% or higher. Conclusion MODY5 is not uncommon in China. The Faguer score is helpful in deciding whether to perform MLPA analysis on patients with negative sequencing results.