Objective To analyze the global distribution characteristics,sequence typing(ST),and the distribution of van genes in Enterococcus faecium globally to provide reference for the prevention,control and clinical treatment of glycopeptide-resistant strains in-fection.Methods This study used Aspera software to download all Enterococcus faecium genome sequence data from NCBI in batches up to December 7,2023.The nucleotide sequences and strain metadata of all genomes were then extracted from the downloaded GBK files using a Perl script.The sequence data of van resistance genes were obtained from the NCBI Pathogen Antimicrobial Resistance Gene Database and analyzed using BLASTN software to determine their distribution across genomes.For the ST analysis,allele se-quence files for seven housekeeping genes of Enterococcus faecium were downloaded from pubMLST website,and all of the strains were sequence typed using a self-developed ST_tool.Results A total of 2 781 Enterococcus faecium genomes were obtained,with isolation dates ranging from 1920 to 2023,showing an increasing peak of isolation rates observed in 2019.In terms of geographic distribution,China,the United States,and New Zealand accounted for 15.61％(434 strains),12.87％(358 strains),and 5.57％(155 strains)of the isolates,respectively,and ranked in the top three.A total of 771 strains originated from human samples,primarily isolated from u-rine(168 strains),feces(154 strains),and rectal swabs(69 strains).In terms of ST,2 781 Enterococcus faecium strains were clas-sified into 359 STs,with ST16(188 strains,7.29％),ST6(178 strains,6.90％),and ST179(150 strains,5.82％)being the pre-dominant types.On the national level,the dominant STs in the United States,China,and New Zealand were ST6(10.71％),ST16(9.59％),and ST108(67.10％),respectively.Additionally,282 Enterococcus faecium strains carried glycopeptide resistance genes,mainly vanA(207 strains)and vanB(72 strains),with ST108(100 strains)and ST6(43 strains)being the predominant types asso-ciated with vanA and vanB,respectively.Conclusion There are significant regional differences in the distribution of Enterococcus fae-cium globally.The vanA and vanB glycopeptide resistance genes are prevalent among resistant strains and exhibit a trend toward multi-drug resistance evolution,highlighting the need for enhanced clinical monitoring and control measures.

Objective To analyze the global distribution characteristics,sequence typing(ST),and the distribution of van genes in Enterococcus faecium globally to provide reference for the prevention,control and clinical treatment of glycopeptide-resistant strains in-fection.Methods This study used Aspera software to download all Enterococcus faecium genome sequence data from NCBI in batches up to December 7,2023.The nucleotide sequences and strain metadata of all genomes were then extracted from the downloaded GBK files using a Perl script.The sequence data of van resistance genes were obtained from the NCBI Pathogen Antimicrobial Resistance Gene Database and analyzed using BLASTN software to determine their distribution across genomes.For the ST analysis,allele se-quence files for seven housekeeping genes of Enterococcus faecium were downloaded from pubMLST website,and all of the strains were sequence typed using a self-developed ST_tool.Results A total of 2 781 Enterococcus faecium genomes were obtained,with isolation dates ranging from 1920 to 2023,showing an increasing peak of isolation rates observed in 2019.In terms of geographic distribution,China,the United States,and New Zealand accounted for 15.61％(434 strains),12.87％(358 strains),and 5.57％(155 strains)of the isolates,respectively,and ranked in the top three.A total of 771 strains originated from human samples,primarily isolated from u-rine(168 strains),feces(154 strains),and rectal swabs(69 strains).In terms of ST,2 781 Enterococcus faecium strains were clas-sified into 359 STs,with ST16(188 strains,7.29％),ST6(178 strains,6.90％),and ST179(150 strains,5.82％)being the pre-dominant types.On the national level,the dominant STs in the United States,China,and New Zealand were ST6(10.71％),ST16(9.59％),and ST108(67.10％),respectively.Additionally,282 Enterococcus faecium strains carried glycopeptide resistance genes,mainly vanA(207 strains)and vanB(72 strains),with ST108(100 strains)and ST6(43 strains)being the predominant types asso-ciated with vanA and vanB,respectively.Conclusion There are significant regional differences in the distribution of Enterococcus fae-cium globally.The vanA and vanB glycopeptide resistance genes are prevalent among resistant strains and exhibit a trend toward multi-drug resistance evolution,highlighting the need for enhanced clinical monitoring and control measures.

The article describes the epidemiology of spinal cord injury (SCI), the measurement methods and affecting factors of post-traumatic growth of SCI patients and treatment strategy of promoting post-traumatic growth of SCI patients. The purposes of the article are to provide help of promote positive psychological changes and improve the quality of life of SCI patients.

Objective To explore the effects of systematic nursing intervention on psychology and quality of life in primary liver cancer patients undergoing surgery. Methods From January 2014 to December 2016, a total of 160 primary liver cancer patients undergoing surgery were selected as subjects by purposive sampling. All of the patients were divided into observation group and control group by the random number table, 80 cases in each group. Patients of control group were treated with the perioperative conventional nursing. On the basis, patients of observation group accepted systematic nursing intervention. We assessed patients in two groups with the SDS, SAS, Quality of Life of Cancer Patient Core Scale before and after intervention. Results After intervention, the score of SDS and SAS of patients in the observation group was lower than that of the control group with significant differences (P<0.01). Besides, the score of general health, physical functioning, role functioning, emotional functioning, cognitive functioning of patients in the observation group were significantly higher than those of the control group (P<0.05). Conclusions Systematic nursing intervention can improve negative emotions and quality of life of patients ,which is worthy of generalization and application.

Objectives To establish a model of carotid atherosclerotic (AS)stenosis in rabbits and to preliminarily investigate the expression of asparaginyl endopeptidase. Methods Fourteen New Zealand white rabbits were divided into either an model group (n = 8)or a sham operation group (n = 6)according to the random number table. The carotid intima was injured by operation in the model group. The rabbits in both groups were fed with high fat diets containing magnesium for 10 weeks. The rabbits were weighted and their blood lipids were tested every 2 weeks. At the end of the fifth and tenth weeks after procedure,the plaque and vessel stenosis of the rabbits were observed by MRI. At the end of the tenth week after proce-dure,the specimens were collected and sliced. Hematoxylin and eosin (HE)staining was used to observe the pathological changes. Immunohistochemical staining was used to analyze the expression of asparaginyl endopeptidase (AEP). Results One rabbit in the model group died of carotid artery injury. After being fed with high-fat diets,the body quality and the level of blood lipid were increased in the rabbits of both groups compared with those before procedure (all P < 0. 01). At the end of the fifth and tenth weeks after procedure,MRI revealed that the luminal stenosis rates in the operation group were 16 ± 11% and 53 ± 20% respectively. There was significant difference within the group (t = - 4. 83,P < 0. 01). MRI revealed no luminal stenosis twice in the sham operation group. HE staining showed intimal hyperplasia,AS plaque formation,lipid deposition in plaques,macrophage and smooth muscle cells migration and infiltration forming foam cells in the model group. No AS formation was observed in the sham operation group. The expression of AEP was higher in the rabbit carotid artery tissue in the model group,and it expressed rarely in the sham surgery group. The absorbance values were 0. 072 0 ± 0. 028 0 and 0. 002 0 ± 0. 000 9 respectively. There was significant difference (t = 6. 61,P < 0. 01). Conclusions The methods of injuring carotid intima combined with magnesium containing high-fat diet may exactly,reliably,and quickly establish an AS carotid artery stenosis model. AEP may associat with the occurrence of AS plaques.