Objective:To explore the ultrasound changes,clinical efficacy and safety of ultrasound-guided compound betamethasone injection in the treatment of first metatarsophalangeal joint(MTP1)in acute gouty arthritis.Methods:This study was a prospective randomized controlled trial,71 patients diagnosed with MTP1 in acute gouty arthritis in Weifang People's Hospital from June 2022 to June 2024 were selected,they were divided into puncture treatment group of 36 cases and oral medication group of 35 cases according to the random number table method.The puncture treatment group was treated with ultrasound-guided compound betamethasone injection,and the oral medication group was treated with etocoxib combined with colchicine.Visual Analogue Scale(VAS),inflammatory indicators[erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)],and semi-quantitative scores of musculoskeletal ultrasound of the two groups were compared,and the medication safety of the two groups was observed.Result:1,3 and 7 days after treatment,VAS score in the puncture treatment group decreased significantly compared with that in the oral medication group(P＜0.05).7 days after treatment,ESR and CRP in the puncture treatment group decreased more significantly,and semi-quantitative scores of musculoskeletal ultrasound showed that the improvement of joint effusion,synovial hyperplasia and blood flow signal was better than that in the oral medication group(P＜0.05).All 36 cases of puncture were successful at the first attempt without complications.Conclusion:Ultrasound-guided compound betamethasone injection in the treatment of MTP1 in acute gouty arthritis has a high success rate,it can rapidly reduce inflammation,relieve pain,restore joint function,and is safe to operate,it can be used as an effective treatment option.

Objective To examine the changing prevalence and antimicrobial resistance profiles of Burkholderia cepacia in 52 hospitals across China from 2015 to 2021.Methods A total of 9 261 strains of B.cepacia were collected from 52 hospitals between January 1,2015 and December 31,2021.Antimicrobial susceptibility of the strains was tested using Kirby-Bauer method or automated antimicrobial susceptibility testing systems according to a unified protocol.The results were interpreted according to the breakpoints released in the Clinical & Laboratory Standards Institute(CLSI)guidelines(2023 edition).Results A total of 9 261 strains of B.cepacia were isolated from all age groups,especially elderly patients.The proportion was 11.1％(1 032 strains)in children,significantly lower than the proportion in adults.About half(46.5％,4 310/9 261)of the strains were isolated from patients at least 60 years old and 42.3％(3 919/9 261)of the strains were isolated from young adults.Most isolates(71.1％)were isolated from sputum and respiratory secretions,followed by urine(10.7％)and blood samples(8.1％).B.cepacia isolates were highly susceptible to the five antimicrobial agents recommended in the CLSI M100 document(33rd edition,2023).B.cepacia isolates showed relatively higher resistance rates to meropenem and levofloxacin.However,the resistance rates to ceftazidime,trimethoprim-sulfamethoxazole,and minocycline remained below 8.1％.The percentage of B.cepacia strains resistant to levofloxacin was the highest compared to other antibiotics in any of the three age groups(from 12.4％in the patients＜18 years old to 20.6％in the patients aged 60 years or older).Conclusions B.cepacia is one of the clinically important non-fermenting gram-negative bacteria.Accurate and timely reporting of antimicrobial susceptibility test results and ongoing antimicrobial resistance surveillance are helpful for rational prescription of antimicrobial agents and proper prevention and control of nosocomial infections.

Ventricular fibrillation is one of the fatal complications of acute myocardial infarction and a common type of reperfusion arrhythmia encountered during emergency interventional procedures.Electrical defibrillation remains the most effective method for rescuing and correcting ventricular fibrillation.This article reports the case of a middle-aged male patient with acute anterior myocardial infarction who developed sudden ventricular fibrillation during the procedure.Sinus rhythm was restored after electrical defibrillation,and the interventional surgery was successfully completed.Postoperatively,the patient experienced back pain related to physical activity.Thoracic CT confirmed a thoracic vertebral fracture.After pharmacological treatment,a follow-up examination six months later indicated satisfactory recovery.This case suggests that electrical cardioversion may lead to fractures,and symptomatic patients should undergo thorough examinations in clinical practice.

The coil adverse events in the U.S.Food and Drug Administration Manufacturer and User Facility Device Experience(MAUDE)database from January 2021 to June 2024 were analyzed retrospectively.The risks of coils during the clinical application and their causes were explored with hospital survey and expert demonstration in Shandong Province.Some improving measures were put forward for the safe use of coils,including implementing the main responsibility of the registrant,enhancing the professional skills of the using institutions and strengthening the supervision of the supervisory authorities.[Chinese Medical Equipment Journal,2025,46(6):83-87]

Objective To investigate the antimicrobial resistance of clinical isolates from elderly patients(≥65 years)in major medical institutions across China.Methods Bacterial strains were isolated from elderly patients in 52 hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program during the period from 2015 to 2021.Antimicrobial susceptibility test was carried out by disk diffusion method and automated systems according to the same CHINET protocol.The data were interpreted in accordance with the breakpoints recommended by the Clinical and Laboratory Standards Institute(CLSI)in 2021.Results A total of 514 715 nonduplicate clinical isolates were collected from elderly patients in 52 hospitals from January 1,2015 to December 31,2021.The number of isolates accounted for 34.3％of the total number of clinical isolates from all patients.Overall,21.8％of the 514 715 strains were gram-positive bacteria,and 78.2％were gram-negative bacteria.Majority(90.9％)of the strains were isolated from inpatients.About 42.9％of the strains were isolated from respiratory specimens,and 22.9％were isolated from urine.More than half(60.7％)of the strains were isolated from male patients,and 39.3％isolated from females.About 51.1％of the strains were isolated from patients aged 65-＜75 years.The prevalence of methicillin-resistant strains(MRSA)was 38.8％in 32 190 strains of Staphylococcus aureus.No vancomycin-or linezolid-resistant strains were found.The resistance rate of E.faecalis to most antibiotics was significantly lower than that of Enterococcus faecium,but a few vancomycin-resistant strains(0.2％,1.5％)and linezolid-resistant strains(3.4％,0.3％)were found in E.faecalis and E.faecium.The prevalence of penicillin-susceptible S.pneumoniae(PSSP),penicillin-intermediate S.pneumoniae(PISP),and penicillin-resistant S.pneumoniae(PRSP)was 94.3％,4.0％,and 1.7％in nonmeningitis S.pneumoniae isolates.The resistance rates of Klebsiella spp.(Klebsiella pneumoniae 93.2％)to imipenem and meropenem were 20.9％and 22.3％,respectively.Other Enterobacterales species were highly sensitive to carbapenem antibiotics.Only 1.7％-7.8％of other Enterobacterales strains were resistant to carbapenems.The resistance rates of Acinetobacter spp.(Acinetobacter baumannii 90.6％)to imipenem and meropenem were 68.4％and 70.6％respectively,while 28.5％and 24.3％of P.aeruginosa strains were resistant to imipenem and meropenem,respectively.Conclusions The number of clinical isolates from elderly patients is increasing year by year,especially in the 65-＜75 age group.Respiratory tract isolates were more prevalent in male elderly patients,and urinary tract isolates were more prevalent in female elderly patients.Klebsiella isolates were increasingly resistant to multiple antimicrobial agents,especially carbapenems.Antimicrobial resistance surveillance is helpful for accurate empirical antimicrobial therapy in elderly patients.

Objective To investigate the relationship between the expression of serum solute carrier family member 11 (SLC7A11) and acyl CoA synthase long-chain family member 4 (ACSL4) and the degree of neurological impairment and prognosis in patients with acute cerebral infarction (ACI). Methods 60 ACI patients admitted to the Department of Neurology,Suzhou Jiulong Hospital,School of Medicine,Shanghai Jiaotong University from October 2019 to December 2022 were selected as the ACI group,and 60 healthy people in the same period were taken as a control group. Serum SLC7A11 and ACSL4 levels were detected by enzyme-linked immunosorbent assay(ELISA). According to the degree of neurological impairment[assessed by the National Institutes of Health Stroke Scale (NIHSS)],60 patients with ACI were divided into a mild group(n=41) and a severe group (n=19). According to the prognosis of patients 3 months after discharge[assessed by the modified Rankin scale (mRS) score],60 patients with ACI were divided into good group(n=47) and bad group(n=13),and the serum SLC7A11 and ACSL4 levels of ACI patients in different groups were compared. Pearson correlation was used to analyze the correlation between serum SLC7A11 and ACSL4 levels and the degree of neurological impairment and prognosis,and receiver operating characteristic(ROC) curve was used to analyze the value of serum SLC7A11 and ACSL4 levels in predicting poor prognosis of ACI patients.Results The serum SLC7A11 (16.88±3.19ng/ml)level in ACI group was lower than that in the control group(25.13±5.61ng/ml),and the ACSL4(40.01±4.23ng/ml)level was higher than that in the control group(23.29±5.72ng/ml),with statistical significance (t=9.902,18.205,all P<0.05).Serum SLC7A11(15.16±3.91ng/ml)level in ACI patients in the severe group was lower than that in the mild group(17.68±2.41ng/ml),and ACSL4 (42.08±5.02ng/ml) level was higher than that in a mild group(39.05±3.40ng/ml),the serum SLC7A11(14.25±2.95 ng/ml)level of ACI patients in the bad group was lower than that in the good group(17.61±2.85 ng/ml),and the ACSL4 (43.54±3.87 ng/ml)level was higher than that in the good group(39.03±3.78 ng/ml),and the differences were statistical significance (t=3.070,2.747;3.735,3.789,all P<0.05). Pearson correlation analysis showed that serum SLC7A11 level was negatively correlated with NISS and mRS scores of ACI patients (r=-0.416,-0.378,all P<0.05). The serum ACSL4 level was positively correlated with NISS and mRS scores (r=0.351,0.415,all P<0.05). The AUC (95％ CI) of serum SLC7A11 and ACSL4 in predicting the poor prognosis of ACI patients was 0.810 (0.688～0.900),and the sensitivity and specificity were 68.09％ and 92.31％,respectively,which were better than those of individual detection (Z=2.176,1.977,P=0.030,0.048). Conclusion The combination of serum SLC7A11 and ACSL4 has a high predictive efficiency for the poor prognosis of ACI patients.

Objective To examine the changing prevalence and antimicrobial resistance profiles of Burkholderia cepacia in 52 hospitals across China from 2015 to 2021.Methods A total of 9 261 strains of B.cepacia were collected from 52 hospitals between January 1,2015 and December 31,2021.Antimicrobial susceptibility of the strains was tested using Kirby-Bauer method or automated antimicrobial susceptibility testing systems according to a unified protocol.The results were interpreted according to the breakpoints released in the Clinical & Laboratory Standards Institute(CLSI)guidelines(2023 edition).Results A total of 9 261 strains of B.cepacia were isolated from all age groups,especially elderly patients.The proportion was 11.1％(1 032 strains)in children,significantly lower than the proportion in adults.About half(46.5％,4 310/9 261)of the strains were isolated from patients at least 60 years old and 42.3％(3 919/9 261)of the strains were isolated from young adults.Most isolates(71.1％)were isolated from sputum and respiratory secretions,followed by urine(10.7％)and blood samples(8.1％).B.cepacia isolates were highly susceptible to the five antimicrobial agents recommended in the CLSI M100 document(33rd edition,2023).B.cepacia isolates showed relatively higher resistance rates to meropenem and levofloxacin.However,the resistance rates to ceftazidime,trimethoprim-sulfamethoxazole,and minocycline remained below 8.1％.The percentage of B.cepacia strains resistant to levofloxacin was the highest compared to other antibiotics in any of the three age groups(from 12.4％in the patients＜18 years old to 20.6％in the patients aged 60 years or older).Conclusions B.cepacia is one of the clinically important non-fermenting gram-negative bacteria.Accurate and timely reporting of antimicrobial susceptibility test results and ongoing antimicrobial resistance surveillance are helpful for rational prescription of antimicrobial agents and proper prevention and control of nosocomial infections.

Ventricular fibrillation is one of the fatal complications of acute myocardial infarction and a common type of reperfusion arrhythmia encountered during emergency interventional procedures.Electrical defibrillation remains the most effective method for rescuing and correcting ventricular fibrillation.This article reports the case of a middle-aged male patient with acute anterior myocardial infarction who developed sudden ventricular fibrillation during the procedure.Sinus rhythm was restored after electrical defibrillation,and the interventional surgery was successfully completed.Postoperatively,the patient experienced back pain related to physical activity.Thoracic CT confirmed a thoracic vertebral fracture.After pharmacological treatment,a follow-up examination six months later indicated satisfactory recovery.This case suggests that electrical cardioversion may lead to fractures,and symptomatic patients should undergo thorough examinations in clinical practice.

(rsFC)and their relationship with negative symptoms in schizophrenia patients with predominant negative symptoms(PNS).Methods Fifty-four schizophrenia patients with PNS and sixty-one healthy controls underwent resting-state functional magnetic resonance imaging(fMRI)scans.Data were collected on general demographic information,the Positive and Negative Syndrome Scale(PANSS),the Scale for the Assessment of Negative Symptoms(SANS),and the Temporal Experience of Pleasure Scale(TEPS).Twelve striatal subregions were selected as regions of interest(ROIs)to analyze the rsFC between each ROI and whole-brain voxels.The rsFC values of areas with significant differences were extracted for Pearson correlation analysis with negative symptoms.Results Compared with healthy controls,schizophrenia patients with PNS exhibited decreased rsFC between the right dorsal caudal putamen(DCP)and right insula,left middle frontal gyrus(MFG),right median cingulate and paracingulate gyri(MCC);between the left DCP and right putamen,left insula,left MFG;between the right dorsal rostral putamen(DRP)and bilateral MFG,left insula,right MCC;between the left DRP and right insula,left rolandic operculum;between the right ventral rostral putamen(VRP)and bilateral putamen,left MFG,right MCC;between the left VRP and right insula,left putamen,bilateral MFG,right MCC,left inferior parietal gyrus,excluding supramarginal and angular gyri.Decreased rsFC was also observed between the left ventral caudate/nucleus accumbens(inferior)and right insula,left anterior cingulate cortex,supracallosal,bilateral precuneus(a threshold of P<0.001 in voxel-level with P<0.05 in cluster-lever,corrected for family-wise error,PFWE<0.05/12=0.004).No regions showed increased rsFC in schizophrenia patients with PNS relative to healthy controls.And no significant correlations were found between striatal rsFC and negative symptoms(PBonferroni>0.05).Conclusion Schizophrenia patients with PNS exhibited widespread cortical-striatal functional connectivity abnormalities,particularly reduced rsFC between the putamen and the MFG,MCC and insula.

Objective To investigate the distribution and antimicrobial resistance profiles of clinically isolated Haemophilus influenzae and Moraxella catarrhalis in hospitals across China from 2015 to 2021,and provide evidence for rational use of antimicrobial agents.Methods Data of H.influenzae and M.catarrhalis strains isolated from 2015 to 2021 in CHINET program were collected for analysis,and antimicrobial susceptibility testing was performed by disc diffusion method or automated systems according to the uniform protocol of CHINET.The results were interpreted according to the CLSI breakpoints in 2022.Beta-lactamases was detected by using nitrocefin disk.Results From 2015 to 2021,a total of 43 642 strains of Haemophilus species were isolated,accounting for 2.91％of the total clinical isolates and 4.07％of Gram-negative bacteria in CHINET program.Among the 40 437 strains of H.influenzae,66.89％were isolated from children and 33.11％were isolated from adults.More than 90％of the H.influenzae strains were isolated from respiratory tract specimens.The prevalence of β-lactamase was 53.79％in H.influenzae strains.The H.influenzae strains isolated from children showed higher resistance rate than the strains isolated from adults.Overall,779 strains of H.influenzae did not produce β-lactamase but were resistant to ampicillin(BLNAR).Beta-lactamase-producing strains showed significantly higher resistance rates to these antimicrobial agents than the β-lactamase-nonproducing strains.Of the 16 191 M.catarrhalis strains,80.06％were isolated from children and 19.94％isolated from adults.M.catarrhalis strains were mostly susceptible to both amoxicillin-clavulanic acid and cefuroxime,evidenced by resistance rate lower than 2.0％.Conclusions The emergence of antibiotic-resistant H.influenzae due to β-lactamase production poses a challenge for clinical anti-infective treatment.Therefore,it is very important to implement antibiotic resistance surveillance for H.influenzae and guide rational antibiotic use.All local clinical microbiology laboratories should actively improve antibiotic susceptibility testing and strengthen antibiotic resistance surveillance for H.influenzae.