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 observe the effect of combining transcutaneous stimulation of the auricular vagus nerve (taVNS) with modified constraint-induced movement therapy (mCIMT) on the upper limb function of hemiplegic stroke survivors.Methods:Seventy-one hemiplegic stroke survivors were randomly divided into a taVNS group of 24, an mCIMT group of 23 and a combined group of 24. In addition to conventional rehabilitation therapy, the taVNS group received taVNS therapy, the mCIMT group received mCIMT, while the combined group received both for 30 minutes a day, 5 days a week for 4 weeks. Before and after the treatment, everyone′s upper limb function was evaluated using the Fugl-Meyer upper extremity assessment (FMA-UE) and the Action Research arm test (ARAT). Ability in the activities of daily living (ADL) was quantified using the modified Barthel index (MBI). The latency and amplitude of motor evoked potentials (MEPs) were also measured.Results:After the treatment, significant improvement was observed in the average FMA-UE, ARAT and MBI scores. MEP latency and amplitude had also improved. The averages in the mCIMT group were then significantly better than among the taVNS group.Conclusions:taVNS combined with mCIMT can significantly improve the upper limb function and ADL functioning of stroke survivors with hemiplegia. It can also promote the recovery of central nervous system function.

Objective:To observe the effect of combining transcutaneous stimulation of the auricular vagus nerve (taVNS) with modified constraint-induced movement therapy (mCIMT) on the upper limb function of hemiplegic stroke survivors.Methods:Seventy-one hemiplegic stroke survivors were randomly divided into a taVNS group of 24, an mCIMT group of 23 and a combined group of 24. In addition to conventional rehabilitation therapy, the taVNS group received taVNS therapy, the mCIMT group received mCIMT, while the combined group received both for 30 minutes a day, 5 days a week for 4 weeks. Before and after the treatment, everyone′s upper limb function was evaluated using the Fugl-Meyer upper extremity assessment (FMA-UE) and the Action Research arm test (ARAT). Ability in the activities of daily living (ADL) was quantified using the modified Barthel index (MBI). The latency and amplitude of motor evoked potentials (MEPs) were also measured.Results:After the treatment, significant improvement was observed in the average FMA-UE, ARAT and MBI scores. MEP latency and amplitude had also improved. The averages in the mCIMT group were then significantly better than among the taVNS group.Conclusions:taVNS combined with mCIMT can significantly improve the upper limb function and ADL functioning of stroke survivors with hemiplegia. It can also promote the recovery of central nervous system function.

Acute large vessel occlusion stroke(ALVOS)of anterior circulation is associated with severe clinical manifestations and high rates of disability and mortality.Mechanical thrombectomy has emerged as the primary therapeutic intervention.However,post-procedural outcomes remain highly variable,and patients continue to face elevated risks of poor prognosis.Machine learning,a transformative tool in medical research,enables comprehensive analysis of multimodal data to identify specific biomarkers and improve the accuracy of predictions for clinical outcomes and adverse events.This review summarized the latest developments in machine learning applications aim at predicting post-thrombectomy prognosis and risk of adverse event,including futile recanalization,hemorrhagic transformation,and malignant cerebral edema in patients with anterior circulation ALVOS in order to provide a basis for developing personalized treatment plan and improve their clinical prognosis.

The"ying-wei imbalance"theory originates from Inner Canon of Yellow Emperor,which refers to the dynamic pathological process of yingfen and weifen circulation,distribution,posture,strength,and weakness due to internal and external disturbance,emphasizing that"ying-wei imbalance"is the key to disease occurrence.The sanjiao,as the"envoy of primordial qi,"is central to yingfen and weifen,and the coordinated operation of yingfen and weifen depends on the promotion of the qi of sanjiao.Therefore,based on the yingfen and weifen theory and sanjiao differentiation and treatment,this paper discusses the etiology and pathogenesis of chronic pulmonary heart disease,as well as the syndrome differentiation approach."Ying-wei imbalance"is the core of this mechanism:in the early stage,the loss of yingfen and weifen nutrition,combined with the deficiency of the qi of sanjiao,allows exogenous pathogens to invade the lungs.During progression,dysfunction in the transportation function of yingfen and weifen,along with the stagnation of the qi of sanjiao,results in pulmonary and cardiac involvement,accompanied by phlegm accumulation and stagnation.The end stage is characterized by the failure of both ying and wei,along with dysfunction of the sanjiao and zang-fu organs,which interact to form a pathological chain of"qi disease involving body."Accordingly,the treatment principle of"harmonizing yingfen and weifen,giving sanjiao treatment"was proposed.This is implemented through three therapeutic strategies:"harmonizing""returning",and"astringing"aimed at restoring balance.In the early stage,treatment focuses on tonifying the lungs and consolidating the exterior to eliminate pathogenic factors and activate stagnation.The selected formula is Buyuan Decoction with modifications to harmonize sanjiao.During the developmental stage,treatment focuses on promoting collaterals and dispersing phlegm,utilizing the modified Xuefu Zhuyu Decocotion to facilitate the restoration of function to the sanjiao.In the final stage,Fuyang Decoction,with modifications,is used to resolve fluid retention and nourish both qi and blood.Discussions are closely focused on the syndrome differentiation system of"sanjiao-yingfen and weifen,"in order to offer a novel perspective on the management of chronic pulmonary heart disease.

BACKGROUND:Magnesium and magnesium-based materials have good biocompatibility,stable osteogenic properties,and biological activities such as vascularization and immune regulation,and show a broad application prospect in stomatology.OBJECTIVE:To summarize the mechanism of magnesium-based materials in the treatment of oral diseases in terms of osteogenesis,angiogenesis,and immunomodulation,and to review the application prospects of magnesium and magnesium-based materials in the field of oral diseases in recent years.METHODS:Chinese search key words were"magnesium,magnesium alloys,magnesium-based metals,fractures,implants,restorations,endodontics,periodontitis,periodontal disease,cysts,oral cancer."English search key works were"magnesium,magnesium-based alloy,fracture,facial bone fractures,denture,dental implant,restorative dentistry,pulpitis,periodontitis,periodontal diseases,oral cancer."The articles were retrieved on CNKI,WanFang,PubMed,and Web of Science databases.By analyzing and reading literature for screening,84 articles were finally included for review.RESULTS AND CONCLUSION:Magnesium and magnesium-based materials can be used as bone internal fixation devices for jaw fracture or orthognathic surgery.Due to the special biological properties of magnesium,it can not only ensure stable osteogenesis,but also avoid the possibility of secondary surgery,which has the potential to be widely used.In the field of bone regeneration in stomatology,magnesium,relying on its superior biological properties,shows better mechanical properties and antibacterial properties than existing clinical materials,providing more options for the development and application of materials in this field.With the help of the biological activity of magnesium,magnesium-based coating materials give full play to the anti-inflammatory and antioxidant effects,further promote implant bone bonding and soft tissue integration,and have great application prospects in implant surface modification and promoting implant stability.Although magnesium has been involved in maxillofacial intraoral soft tissue regeneration and treatment,dental tissue engineering,there are still a lot of gaps.To ensure the stable biological characteristics of magnesium,it is usually necessary to add other alloys or carry out magnesium surface modification.However,the biological evaluation system of degradable metal implants is not perfect at present.The clinical application of magnesium in oral diseases still needs to be further clarified in the future.

Objective:To describe the temporal trend of disease burden of idiopathic epilepsy in China from 1990 to 2021 and predict the incidence of idiopathic epilepsy in China from 2022 to 2035 to provide references for the formulation of relevant health policies and measures.Methods:Based on data from the Global Burden of Disease Study 2021 (GBD 2021) database regarding idiopathic epilepsy in China, changes in disease burden from 1990 to 2021 were acquired. Disease burden was quantified using age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), age-standardized disability-adjusted life years (DALYs) rate (ASDR) and their 95% uncertain interval (UI). Temporal trend analysis was performed using a linear regression model to estimate the estimated annual percent change (EAPC) and annual percentage change (APC) in incidence of idiopathic epilepsy and their 95% CI. Additionally, incidence and number of patients with idiopathic epilepsy in China from 2022 to 2035 were predicted using Bayesian age-period-cohort model. Results:The ASIR of idiopathic epilepsy increased from 22.35 per 100,000 population in 1990 (95% UI: 15.04-30.92 per 100,000 population) to 28.19 per 100,000 population in 2021 (95% UI: 19.03-37.89 per 100,000 population), with an EAPC of 0.12% (95% CI: -0.10%-0.34%); ASPR of idiopathic epilepsy increased from 189.27 per 100,000 population in 1990 (95% UI: 132.48-252.95 per 100,000 population) to 214.71 per 100,000 population in 2021 (95% UI: 150.10-278.56 per 100,000 population), with an EAPC of -0.32% (95% CI: -0.57%-0.06%); ASMR of idiopathic epilepsy decreased from 1.86 per 100,000 population in 1990 (95% UI: 1.59-2.24 per 100,000 population) to 0.80 per 100,000 population in 2021 (95% UI: 0.67-1.00 per 100,000 population), with an EAPC of -2.96% (95% CI: -3.09%-2.82%); ASDR of idiopathic epilepsy decreased from 178.60 per 100,000 population in 1990 (95% UI: 143.44-220.63 per 100,000 population) to 101.39 per 100,000 population in 2021 (95% UI: 72.51-139.40 per 100,000 population), with an EAPC of -2.38% (95% CI: -2.54%-2.22%). The prediction model showed that by 2035, the prevalence of idiopathic epilepsy in China will be 28.27 per 100,000 (95% CI: 23.19-38.66), with an estimated 394,928 incident cases (95% CI: 324,037-540,128). Conclusions:From 1990 to 2021, the ASIR and ASPR of idiopathic epilepsy in China show an upward trend, while the ASMR and ASDR hace a decline trend. Incidence of idiopathic epilepsy in China is expected to remain stable over the next decade.

BACKGROUND:Magnesium and magnesium-based materials have good biocompatibility,stable osteogenic properties,and biological activities such as vascularization and immune regulation,and show a broad application prospect in stomatology.OBJECTIVE:To summarize the mechanism of magnesium-based materials in the treatment of oral diseases in terms of osteogenesis,angiogenesis,and immunomodulation,and to review the application prospects of magnesium and magnesium-based materials in the field of oral diseases in recent years.METHODS:Chinese search key words were"magnesium,magnesium alloys,magnesium-based metals,fractures,implants,restorations,endodontics,periodontitis,periodontal disease,cysts,oral cancer."English search key works were"magnesium,magnesium-based alloy,fracture,facial bone fractures,denture,dental implant,restorative dentistry,pulpitis,periodontitis,periodontal diseases,oral cancer."The articles were retrieved on CNKI,WanFang,PubMed,and Web of Science databases.By analyzing and reading literature for screening,84 articles were finally included for review.RESULTS AND CONCLUSION:Magnesium and magnesium-based materials can be used as bone internal fixation devices for jaw fracture or orthognathic surgery.Due to the special biological properties of magnesium,it can not only ensure stable osteogenesis,but also avoid the possibility of secondary surgery,which has the potential to be widely used.In the field of bone regeneration in stomatology,magnesium,relying on its superior biological properties,shows better mechanical properties and antibacterial properties than existing clinical materials,providing more options for the development and application of materials in this field.With the help of the biological activity of magnesium,magnesium-based coating materials give full play to the anti-inflammatory and antioxidant effects,further promote implant bone bonding and soft tissue integration,and have great application prospects in implant surface modification and promoting implant stability.Although magnesium has been involved in maxillofacial intraoral soft tissue regeneration and treatment,dental tissue engineering,there are still a lot of gaps.To ensure the stable biological characteristics of magnesium,it is usually necessary to add other alloys or carry out magnesium surface modification.However,the biological evaluation system of degradable metal implants is not perfect at present.The clinical application of magnesium in oral diseases still needs to be further clarified in the future.

The"ying-wei imbalance"theory originates from Inner Canon of Yellow Emperor,which refers to the dynamic pathological process of yingfen and weifen circulation,distribution,posture,strength,and weakness due to internal and external disturbance,emphasizing that"ying-wei imbalance"is the key to disease occurrence.The sanjiao,as the"envoy of primordial qi,"is central to yingfen and weifen,and the coordinated operation of yingfen and weifen depends on the promotion of the qi of sanjiao.Therefore,based on the yingfen and weifen theory and sanjiao differentiation and treatment,this paper discusses the etiology and pathogenesis of chronic pulmonary heart disease,as well as the syndrome differentiation approach."Ying-wei imbalance"is the core of this mechanism:in the early stage,the loss of yingfen and weifen nutrition,combined with the deficiency of the qi of sanjiao,allows exogenous pathogens to invade the lungs.During progression,dysfunction in the transportation function of yingfen and weifen,along with the stagnation of the qi of sanjiao,results in pulmonary and cardiac involvement,accompanied by phlegm accumulation and stagnation.The end stage is characterized by the failure of both ying and wei,along with dysfunction of the sanjiao and zang-fu organs,which interact to form a pathological chain of"qi disease involving body."Accordingly,the treatment principle of"harmonizing yingfen and weifen,giving sanjiao treatment"was proposed.This is implemented through three therapeutic strategies:"harmonizing""returning",and"astringing"aimed at restoring balance.In the early stage,treatment focuses on tonifying the lungs and consolidating the exterior to eliminate pathogenic factors and activate stagnation.The selected formula is Buyuan Decoction with modifications to harmonize sanjiao.During the developmental stage,treatment focuses on promoting collaterals and dispersing phlegm,utilizing the modified Xuefu Zhuyu Decocotion to facilitate the restoration of function to the sanjiao.In the final stage,Fuyang Decoction,with modifications,is used to resolve fluid retention and nourish both qi and blood.Discussions are closely focused on the syndrome differentiation system of"sanjiao-yingfen and weifen,"in order to offer a novel perspective on the management of chronic pulmonary heart disease.

Objective:To explore the influences of FibroScan detection on the pregnancy outcomes of pregnant rats transfected with hepatitis B virus and the growth of their offspring rats.Methods:Sixty SPF-grade SD rats with a male-to-female ratio of 5∶1 were selected，randomly divided the female rats into the groups of mid-pregnancy with hepatitis B，late-pregnancy with hepatitis B，normal mid-pregnancy，normal late-pregnancy，and control group，and the rats in the mid-pregnancy and late-pregnancy groups were subjected to FibroScan testing on the 10th and 15th days of gestation respectively. The number of offspring rats in each group was randomly reduced to 10 on the 3rd day after delivery，and the offspring rats were divided into the groups of mid-pregnancy with hepatitis B，late-pregnancy with hepatitis B，normal mid-pregnancy，normal late-pregnancy，and control group. The pregnancy outcome levels of pregnant rats were observed by adopting a stratified analysis strategy，including differences in weight changes，number of deliveries，fetal rat outcomes，lactation conditions，litter size，and litter weight. The growth levels of offspring rats，including differences in weight，body length，tail length，and the time of fur growth，tooth eruption，eye opening，and ear standing on the 21st day were observed，and the survival rate of the offspring rats was compared.Results:With regard to the pregnancy outcome levels of the pregnant rats，there were no statistically significant differences in weight changes during pregnancy among the five groups of pregnant rats［ F（4，45）=2.627，Adjusted P=0.222］. There were also no statistically significant differences in the number of deliveries，fetal rat outcomes，and lactation conditions（Adjusted P=1.000）. The number of deliveries［ F（4，21.095）=2.280，Adjusted P=0.222］and litter weight［ F（4，20.128）=2.159，Adjusted P=0.222］showed no statistically significant differences. After correction using the BH method，none of the indicators showed significant differences（ P>0.05）. In terms of the growth levels of the offspring rats，among the five groups of offspring rats，there were no statistically significant differences in body weight on the 21st day［H（4）=11.623，Adjusted P=0.135］，body length on the 21st day［H（4）=10.962，Adjusted P=0.135］，and tail length on the 21st day［H（4）=9.126，Adjusted P=0.058］. Besides，the differences in the time of fur growth，tooth eruption，eye opening，and ear standing［H（4）=0.000，Adjust P=1.000］showed no statistical significance. The survival rate on the 7th day，14th day，and 21st day was 100%，with no significant differences（Adjusted P=1.000）. After correction using the BH method，none of the indicators showed significant differences（ P>0.05）. Conclusion:FibroScan detection had no significant influences on the pregnancy outcomes of pregnant rats with hepatitis B or on the growth of their offspring rats in multiple stages，dimensions，and indicators，indicating that FibroScan detection is safe for pregnant rats. This research provides an animal experimental basis for the safe use of FibroScan in pregnant women with chronic HBV infection.