Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Objective To explore the anti-atherosclerosis mechanism of Hirudo and its effect on autophagy in mice.Methods Forty healthy male ApoE-/-mice were randomly divided into model group,control group(3 × 10-3 g·kg-1·d-1 simvastatin)and experimental-L,experimental-M,experimental-H groups(0.45,0.9,1.8 g·kg-1· d-1,Maixuekang capsule).Eight healthy male C57BL/6J mice were divided into blank group.The mice were fed with common diet for 1 week.Then,except blank group,other groups were fed with high-fat diet.After 8 weeks of modeling,the atherosclerosis(AS)mice were given drugs orally once a day for 12 weeks,and fed with high-fat diet in the meantime.The levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)in serum were determined by enzyme-linked immunosorbent assay(ELISA).The levels of Beclin-1,LC3 autophagy protein were detected by Western blot method.Results The IL-6 contents in the experimental-H,experimental-M,experimental-L,control,model and blank groups were(107.59±3.03),(99.31±5.12),(103.52±2.28),(98.68±4.68),(112.66±6.08),(93.98±3.43)pg·mL-1;the TNF-α contents were(538.41±30.26),(504.49±21.51),(538.51±19.05),(494.05±25.08),(578.53±26.32),(467.35±21.53)pg·mL-1.For the above indexes,the differences between model group and experimental-H group,experimental-M group,experimental-L group,control group,blank group were all statistically significant(all P＜0.05).The Beclin-1 protein expression levels in the experimental-H,experimental-M,experimental-L,control and model groups were 1.48±0.05,1.72±0.05,1.19±0.02,1.51±0.04,0.66±0.03;the LC3 Ⅱ protein expression levels were 1.53±0.01,1.83±0.02,1.16±0.01,1.90±0.01,0.49±0.01,and the differences between model group and experimental-H group,experimental-M group,experimental-L group,control group were all statistically significant(all P＜0.05).Conclusion Hirudo can significantly reduce the area of atherosclerotic plaque by regulating the level of autophagy.

Biological matrix reference material is a reference material that combines the target material with the biological matrix. The biological matrix reference material has higher consistency with the authentic specimens in forensic toxicology, and its application has a positive effect on improving the accuracy of test results. This paper reviews the research on the matrix reference materials corresponding to three common biological test materials (blood, urine and hair). In order to provide reference for the development and application of biological matrix reference materials in forensic toxicology, this paper mainly introduces the research progress of preparation technology of biological matrix reference materials and some existing products and their parameters evaluation.
Forensic Toxicology/methods* ; Hair ; Body Fluids

This paper explored the background, framework and approach, contents and implementation of WHO Rehabilitation in Health System using approaches of ICF and WHO Handbook for Guideline Development. The actions and significances of implementations of seven recommendations and one good practice statements on assistive products had been discussed.

Objective:To investigate the role of IL-17D to regulate the recruitment of lung NK cells and the effects of Astragalus membranaceus on IL-17D.Methods:The lung metastasis of tumor model was established by injecting B16 melanoma cells through caudal vein.After being treated with IL-17D or Astragalus membranaceus respectively,the expression of IL-17D and NK cells in lung was detected by flow cytometry and RT-PCR.Results:The production of IL-17D and the content of NK cells in the lung tumor me-tastasis model were dramatically decreased.After treatment with IL-17D,the content of NK cells in lung was significantly increased and the lung tumor foci were decreased.Along with up-regulated recruitments of NK cells,CXCL9 and IL-15,which support NK cell recruitments and maintain survival,were significantly increased.Astragalus inhibited lung tumor developments in lung by increasing the IL-17D expression and up-regulated the lung NK cell content.Conclusion: IL-17D can regulate the lung recruitment of NK cells.Astragalus mongholicus can enhance the capacity of NK cell recruitment and promote anti-tumor immune effects by up-regulating the expression of IL-17D.

AIM To study the protective effects of Jingqi Capsules (Cordycps Militaris,Rehmanniae Radix Praeparata,Lycii Fructus,) on the damage to rat reproductive system induced by cyclophosphamide.METHODS After low and high dose groups of Jingqi Capsules and positive group were administered for two weeks in advance,cyclophosphamide [25 mg/(kg · d)] modeling was conducted consecutively by intraperitoneal injection for five days except the normal group,while the treatment groups were administered consecutively.All the rats were executed the day after the end of the modeling.Serum testosterone content was measured by radioimmunoassay;body weight,testis,epididymis and prostate of rats were weighed and organ coefficient was calculated;morphology of testis was observed by HE;sperm count and sperm motility were detected by CASA;apoptosis of cells was observed by TUNEL.RESULTS Compared with the model group,each dose group of Jingqi Capsules increased in the level of serum testosterone and organ coefficient of testis,epididymis and prostate.The damage to seminiferous epithelium relieved and the number of all spermatogenic cells increased.Sperm count and sperm motility increased.Decrease in apoptosis of cells was demonstrated by TUNEL.CONCLUSION Jingqi Capsules has protective effects on damage to rat reproductive system induced by cyclophosphamide.

Objective:To explore and analyze the points-selection rules in acupuncture treatment of mammary gland hyperplasia (MGH) by data mining and statistical method. Methods:Clinical literatures about the treatment of MGH with acupuncture published in the recent 16 years were retrieved from Chinese Journal Full-text Database (CJFD) and established into a database by Excel. The SPSS 20 version software and Clementine 12.0 version software were adopted to analyze the frequency and association rules of points-selection in the treatment of MGH with acupuncture. Results:The top 3 points used most frequently in acupuncture treatment of MGH were Danzhong (CV 17), Taichong (LR 3) and Zusanli (ST 36); points from the Stomach Meridian of Foot Yangming and Liver Meridian of Foot Jueyin were most commonly used; the commonly selected points were predominantly distributed in thoracic and abdominal regions and lower limbs; emphasis on the combination use of local and distal points; of the specific points, the five Shu-Transmitting points were mostly used; association analysis showed that the associations among Taichong (LR 3), Danzhong (CV 17) and Zusanli (ST 36) were the most significant. Conclusion: The data mining results substantially accord with the general rules of acupuncture-moxibustion theories in traditional Chinese medicine, able to reflect the points-selection principles and features in acupuncture treatment of MGH and provide evidence for the points selection in the treatment of MGH in acupuncture clinic.

To investigate the effects of cryptotanshinone (an active ingredient of Salvia Miltiorrhiza) inhibition of angiogenesis, the toxicity of cryptotanshinone was assayed in human hepatic sinusoidal endothelial cells (HHSEC) by CCK8 method. Max dose without toxicity is 10 μmol·L^-1. The proliferation of HHSEC were induced by the endothelial cell growth supplement (ECGS), with 2.5 μmol·L^-1 sorafenib as the positive control. Cell proliferation was analyzed by EdU assay. Cell viability was analyzed by CCK8 method. The expression of vWF was analyzed by immunofluorescence method. Fluorescence probe method was used to detect the intracellular nitric oxide (NO) levels. Tube formation of HHSEC and transgenic zebrafish were also observed to evaluate the effects of cryptotanshinone against angiogenesis. Compared with normal control, there is a proliferation of HHSEC induced by ECGS. The expression of vWF and the NO levels increased significantly. Cryptotanshinone inhibited the proliferation, down regulated the expression of vWF and the NO levels. Further, cryptotanshinone inhibited the tube formation of HHSEC and reduced the number of fu nctional vessels in transgenic zebrafish. The results suggest that cryptotanshinone could inhibit angiogenesis by regulating the HHSEC cell function.

Breast Neoplasms, Male ; diagnosis ; Humans ; Male ; Nasal Cavity ; Nose Neoplasms ; diagnosis ; secondary

OBJECTIVETo study the MSCT features and diagnosis of foot and ankle tendon injury and improve the recognition to avoid the missed.

METHODSFrom January 2009 to December 2010, 32 patients suspected of foot and ankle tendon injury were enrolled and included 24 males and 8 females with an average age of 43 years ranging from 23 to 68 years. All patients had pain, tenderness, swelling or disfunction in the diseased foot and were finally confirmed with surgery, MRI, contralateral contrast and followed-up. The MSCT was performed with a multi-detector CT scanner (Emotion 6; Siemens) within 7 days after injury. Two experienced radiologists evaluated the tendon abnormalities before told the outcome.

RESULTSWith 5 patients lost, the final study included 27 patients. Thirty-one tendon injuries were finally confirmed in 23 cases. Thirty-five tendon abnormalities were diagnosed on CT images among all 243 tendons but 4 of them were misdiagnoses. The CT overall diagnostic sensitivity, specificity, and accuracy was 88.8% (31/35), 98.1% (208/212), and 98.4% (239/243). Eleven tendon dislocations showed as the tendon partially or completely off the tendon groove. Thirteen tendon entrapment showed no less than half section of the tendon embedded the fracture in the axial images, and 7 tendons located in the fracture gap or 6 tendons closely related with widened fracture in VR images (2 misdiagnosis). Four bone chip insertion showed the chip inserted in the tendons both in the axial images and VR images (1 misdiagnosis). Four tendon ruptures showed discontinuity and shortening of the tendon (1 misdiagnosis). Three tendon injuries showed thickening, density reduction and blurring of tendons, and misty surrounding fat space.

CONCLUSIONWith comprehensive MSCT examination (thin-slice scanning and volume rendering) of foot and ankle, the tendon dislocation, tendon entrapment, bone chip intercalation, and tendon rupture/injury could be confidently diagnose.

Adult ; Aged ; Ankle Injuries ; diagnostic imaging ; Diagnostic Errors ; Female ; Foot Injuries ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography ; methods ; Tendon Injuries ; diagnostic imaging