Antimicrobial resistance (AMR) is a major global public health challenge. In addition to antibiotic selection pressure, insecticides have attracted increasing attention as widely used non-antibiotic chemicals that may contribute to the emergence and dissemination of bacterial resistance in the environment. This review focused on common insecticides, including organophosphorus insecticides, pyrethroids, and neonicotinoids, and summarized current evidence on their effects on the emergence of AMR, and the spread of antibiotic resistance genes (ARGs). Existing studies suggest that exposure to certain insecticides may reduce bacterial susceptibility to antibiotics and is associated with the proliferation of antibiotic-resistant bacteria, enrichment of ARGs, co-enrichment of mobile genetic elements (MGEs), and enhanced horizontal gene transfer. Potential mechanisms include changes in antibiotic target-related pathways, decreased membrane permeability, activation of efflux pumps, and enzymatic modification or degradation of antibiotics. The dissemination of ARGs may also be promoted through reactive oxygen species (ROS) accumulation, activation of the SOS response, altered cell membrane permeability, changes in extracellular polymeric substance (EPS) synthesis, altered energy metabolism, and regulation of transfer-related genes. Overall, insecticides may act as non-antibiotic selective pressures involved in the evolution and dissemination of bacterial resistance. However, current evidence is still largely derived from laboratory exposure experiments and cross-sectional investigations, and differences among compounds, and long-term risks under real environmental conditions require further clarified. This review may help improve understanding of the environmental health implications of insecticide-associated bacterial resistance and inform risk assessment and prevention strategies for AMR in environmental settings.

Objective To investigate the incidence and severity of symptoms in patients with gastric cancer who received chemotherapy,we constructed a symptom network to explore core symptoms and bridge symptoms.Furthermore,the study explores the association between core symptoms and Traditional Chinese Medicine(TCM)constitutions.Methods Patients with gastric cancer who received chemotherapy in the medical oncology and surgical oncology department from March to August 2023 were selected for the study using a convenience sampling method.The MD Anderson Symptom Inventory Gastrointestinal Cancer was used for evaluating gastrointestinal symptoms and their severity among patients receiving chemotherapy for gastric cancer,as well as assessing the classification of TCM constitution among patients.The symptom network model was constructed using the R programming language,and the central index was analyzed to determine the core symptoms and bridge symptoms.Binary logistic regression analysis was employed to assess the association between different physical conditions and the occurrence of core symptoms.Results A total of 346 electronic questionnaires were collected,with 340 valid ones,and the effective recovery rate was 98.3％.The 3 most prevalent and severe symptoms among the 340 patients with gastric cancer were fatigue(85.59％),lack of appetite(82.35％),and taste alteration(81.18％).The centrality index results indicated that grief exhibited the highest intensity,medium,and compactness centrality values(rs=8.23,rb=2.00,rc=0.03),making it the core symptom of this condition.Sleep disorders,lack of appetite,drowsiness,and taste alteration were identified as bridging symptoms with bridge intensities of 0.74,0.76,0.99,and 0.94 respectively.The results of Spearman correlation analysis showed that there was a positive correlation between sadness and qi-deficiency constitution,phlegm-dampness constitution(P＜0.05).The phlegm-dampness constitution was positively correlated with the taste alterations(P＜0.05).Conclusion In patients with gastric cancer,fatigue emerges as the most prominent symptom,while sadness assumes the core symptom.Additionally,sleep disorder,lack of appetite,drowsiness,and taste alteration are bridge symptoms.According to the principles of TCM constitution,qi-deficiency and phlegm-dampness are constitutions associated with a higher risk of experiencing sadness,and phlegm-dampness is a constitution associated with a higher risk of taste changes.Nurses can integrate core symptoms and TCM constitutions characteristics to optimize the strategies for symptom intervention.

Objective:To compare the efficacy and safety between WangShiBaoChiWan and mosapride in the treatment of functional dyspepsia (FD).Methods:From September 2019 to September 2020, patients with postprandial fullness and early satiation who met the Rome Ⅳ criteria for FD diagnosis were enrolled from 15 hospitals, including the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical College. The subjects were randomly divided into WangShiBaoChiWan (experimental) group and mosapride (control) group in the ratio of 1∶1. The treatment regimens were WangShiBaoChiWan+ mosapride simulator, WangShiBaoChiWan simulator+ mosapride, respectively with a treatment period of 2 weeks. The primary efficacy outcome was the improvement rates of main symptoms before and after treatment, the secondary efficacy primary efficacy outcome was the total clinical effective rate and the change of the single symptom score. And the safety indicator included adverse events. Independent sample t-test, paired t-test and chi-square test were used for statistical analysis. Results:A total of 251 FD patients were enrolled in the full analysis set, including 124 in the experimental group and 127 in the control group; 241 FD patients were in the per-protocol analysis set, including 117 in the experimental group and 124 in the control group. The analysis of per-protocol analysis set showed that the improvement rates of the main symptoms of the experimental group and the control group were (66±29)% and (60±30)%, respectively, and the difference was not statistically significant ( P>0.05). The improvement rate of the main symptoms of the experimental group reached 117% of that of the control group, which exceeded the expected non-inferiority standard of 80%. The total clinical effective rates of the experimental group and the control group were 76.07% (89/117) and 75.81% (94/124), respectively, and the difference was not statistically significant ( P>0.05). The results of full analysis set showed that the incidence of adverse events of the experimental group and the control group was 1.62% (2/124) and 1.57% (2/127), respectively, and the difference was not statistically significant ( P>0.05). There were no serious adverse events in the two groups. Conclusion:The improvement rate of the main symptoms of WangShiBaoChiWan is not inferior to that of mosapride in the treatment of FD, and it has good safety.

Objective:To investigate the anti-syphilis treatment status among pregnant women with syphilis and its influencing factors, and to explore the relationship between the treatment status and pregnancy outcome.Methods:Through the National Information System for the Prevention of Mother-to-child Transmission of acquired immune deficiency syndrome (AIDS), Syphilis and Hepatitis B, the demographic data, anti-syphilis treatment status during pregnancy and pregnancy outcomes of 1 614 pregnant women with syphilis who gave birth in Guangzhou City from January 2013 to December 2016 were collected. Chi-square test was used for comparison between groups and logistic regression method was used to identify influence factors of syphilis treatment and adverse pregnancy outcomes.Results:A total of 1 614 pregnant women with syphilis were included. The rates of standard treatment, general treatment and no treatment were 37.17%(600/1 614), 40.77%(658/1 614) and 22.06%(356/1 614), respectively. Logistic regression analysis showed that the rate of standard treatment was lower in the women with nonlocal registered permanent residence (adjusted odds ratio ( aOR)=0.670, 95% confidence interval ( CI) 0.523-0.858, P=0.002), unmarried ( aOR=0.582, 95% CI 0.393-0.863, P=0.007), education level of high school ( aOR=0.691, 95% CI 0.507-0.943, P=0.020), education level of junior middle school or below ( aOR=0.607, 95% CI 0.459-0.803, P<0.01), diagnosis after 28 weeks ( aOR=0.088, 95% CI 0.062-0.125, P<0.01) and unknown non-treponema pallidum antigen serologic test result at the time of diagnosis ( aOR=0.459, 95% CI 0.297-0.710, P=0.001). After controlling other related factors, compared with standard treatment group, the risk of adverse pregnancy outcome was increased in general treatment and untreated group, with aOR of 1.553 (95% CI 1.079-2.234, P=0.018) and 2.097 (95% CI 1.347-3.267, P<0.01), respectively. Compared to mothers with non-treponema pallidum antigen serologic test result ≤1∶4 at the time of diagnosis, the risk for adverse pregnancy outcome was significantly increased in mothers with non-treponema pallidum antigen serologic test result ≥1∶8 ( aOR=1.542, 95% CI 1.105-2.152, P=0.011). Compared to mothers with negative non-treponema pallidum antigen serologic test result at the last test during pregnancy, the risk for adverse pregnancy outcome was significantly increased in mothers with non-treponema pallidum antigen serologic test result ≥1∶8 ( aOR=2.063, 95% CI 1.151-3.700, P=0.015). Conclusion:Early diagnosis of syphilis, standard treatment and follow-up during pregnancy can effectively improve the pregnancy outcomes of pregnant women with syphilis.

[Objective] To study the influence on humoral immunity and ectopic endometrium by infusion of Bushen Tiaojing Decoction (BTD) with the Huoxue Sanjie Suppository (HSS) in anus. [Methods] One hundred and thirty SD rats were allocated to ten groups: normal control (A), model (B), normal dose of HSS (C), normal dose of BTD with HSS (D), 3 doses of BTD (E), 3 doses of BTD with HSS (F), 5 doses of BTD (G), 5 doses of HSS (H), 5 doses of BTD with HSS (I), and Danazol (J) groups. The endometriosis (EM) rats were modeled by endometrium implantation in all groups except those in Group A. Four weeks after the treatment, the contents of immunoglobulin (IgG、IgM、IgA), C_3, C_4 and ALT were tested, and histomorphomological analysis of the thymus, ovary, uterus, EM implants, liver and kidney were performed. [Results] Four weeks after EM implantation, the ectopic endometria were growing well, IgG and C_3 increased, but IgM decreased, and the uterus and ovary significantly enlarged. With the treatment of BTD and HSS or Danazol, the ectopic endometria were atrophied. In Groups F and G, IgG decreased; in Groups H and I, C_3 decreased, and uterus and ovary shrunk in Group I. Danazol can help to prolong the sexual cycle, while BTD and HSS can not. In all the medication groups, no obvious difference was found in ALT of the rats. [Conclusion] Oral administration of BTD with HSS can cause endometrial atrophy and improve humoral immunity in model rats.