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.

Objective To study the effect of practicing traditional Chinese medicine(TCM)guidance on the health in weightless conditions based on the examination results of the TCM diagnostic instrument.Methods 6 subjects in weightless conditions practiced TCM guidance for 14 consecutive days,once a day for 8 minutes each time.The Digital TCM Diagnostic Instrument and TCM Syndrome Diagnosis Scale were used to collect information before and after their practice of TCM guidance through diagnostic methods of observation,palpation and inquiry according to TCM theory.The data such as the degree of virtual-reality,pulse rate,and characteristic parameters of pulse diagrams h3/h1,h4/h1,t1,h1/t1 were processed and analyzed,and the changes before and after the practice were compared.Results Compared with before the practice,the degree of deficiency syndrome was significantly reduced after practicing TCM guidance(P<0.05),the pulse rate was significantly decreased(P<0.01),and the pulse diagnosis parameters h3/h1 and t1 were significantly decreased(P<0.05),while h4/h1 and h1/t1 showed no significant changes.Conclusion Practicing TCM guidance in weightless conditions is helpful for enhance cardiovascular regulatory function,correcting symptom bias,adjusting the body's balance state,and has a positive effect on health.

Objective To investigate the relationship between the peak levels of N-terminal pro-B-type natriuretic peptide(NT-proBNP)during hospitalization and the risk of left ventricular ejection fraction(LVEF)＜50％during the recovery period in pa-tients with acute myocardial infarction(AMI).Methods This retrospective cohort study included 220 AMI patients treated at Beijing Friendship Hospital,Capital Medical University from January 2018 to December 2023.The patients were divided into three groups accord-ing to the tripartite value of peak levels of NT-proBNP during hospitalization.Baseline clinical characteristics,laboratory test results,and peak levels of NT-proBNP were collected.The primary outcome was LVEF＜50％during the recovery period.By incorporating con-founding factors,three stepwise complex Logistic regression model and linear regression model were used to analyze the relationship be-tween peak levels of NT-proBNP and the risk of LVEF＜50％.Restricted cubic spline(RCS)was used to explore the nonlinear relation-ship between them.Results The peak levels of NT-proBNP were positively correlated with an increased risk of LVEF＜50％during the recovery period,even after adjusting for confounding factors.RCS analysis revealed the nonlinear relationships between them.When the peak levels of NT-proBNP was 1822.991pg/ml,the sensitivity and specificity of predicting LVEF＜50％were 57.14％and 70.97％.Conclusion The NT-proBNP peak levels of 1822.991 pg/ml is a useful indicator for predicting LVEF＜50％in AMI pa-tients during the recovery period,and it can be used to identify high-risk AMI groups and provide basis for early active intervention.

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.

Objective To investigate the relationship between the peak levels of N-terminal pro-B-type natriuretic peptide(NT-proBNP)during hospitalization and the risk of left ventricular ejection fraction(LVEF)＜50％during the recovery period in pa-tients with acute myocardial infarction(AMI).Methods This retrospective cohort study included 220 AMI patients treated at Beijing Friendship Hospital,Capital Medical University from January 2018 to December 2023.The patients were divided into three groups accord-ing to the tripartite value of peak levels of NT-proBNP during hospitalization.Baseline clinical characteristics,laboratory test results,and peak levels of NT-proBNP were collected.The primary outcome was LVEF＜50％during the recovery period.By incorporating con-founding factors,three stepwise complex Logistic regression model and linear regression model were used to analyze the relationship be-tween peak levels of NT-proBNP and the risk of LVEF＜50％.Restricted cubic spline(RCS)was used to explore the nonlinear relation-ship between them.Results The peak levels of NT-proBNP were positively correlated with an increased risk of LVEF＜50％during the recovery period,even after adjusting for confounding factors.RCS analysis revealed the nonlinear relationships between them.When the peak levels of NT-proBNP was 1822.991pg/ml,the sensitivity and specificity of predicting LVEF＜50％were 57.14％and 70.97％.Conclusion The NT-proBNP peak levels of 1822.991 pg/ml is a useful indicator for predicting LVEF＜50％in AMI pa-tients during the recovery period,and it can be used to identify high-risk AMI groups and provide basis for early active intervention.

Objective To analyze the in-hospital and long term prognosis of acute myocardial infarction(AMI)patients with N-terminal B-type brain natriuretic peptide(NT-proBNP)peak value exceeding the up-per limit.Methods A total of 669 patients with AMI diagnosed in a hospital from 2013 to 2018 were selected as research objects.According to the peak value level of NT-proBNP,they were divided into the NT-proBNP peak value exceeding the upper limit group(50 cases)and the NT-proBNP peak value detectable group(619 cases).Propensity score was used for matching(1:2),and the patients were divided into NT-proBNP peak value exceeding the upper limit group(50 cases)and NT-proBNP peak value detectable group(107 cases),and the in-hospital prognosis and long-term prognosis of the two groups were compared,as well as the echo-cardiographic indexes of each group in the acute stage and recovery stage of AMI.Multiple linear regression a-nalysis was used to predict the factors affecting left ventricular ejection fraction in the recovery stage of AMI.Results After matching the propensity score,compared with the NT-proBNP peak value detectable group,the neutrophil to lymphocyte ratio,hypersensitive C reactive protein level and fibrinogen level in the NT-proBNP peak value exceeding the upper limit group were higher at admission,and the differences were statistically sig-nificant(P＜0.05).The proportion of Killip≥ Grade Ⅱ,left ventricular ejection fraction,hospitalization time and major adverse cardiovascular and cerebrovascular events in the NT-proBNP peak value exceeding the up-per limit group were compared with those in the NT-proBNP peak value detectable group,and the differences were statistically significant(P＜0.05).The left ventricular ejection fraction and left ventricular shortening fraction of the NT-proBNP peak value detection group in AMI acute stage were higher than those in the NT-proBNP peak value exceeding the upper limit group in AMI acute stage,and the difference was statistically significant(P＜0.05).Multiple linear regression analysis showed the relationship between the NT-proBNP peak value during hospitalization and the left ventricular ejection fraction of cardiac function during AMI re-covery.The results suggested that the NT-proBNP peak value was not a risk factor affecting the left ventricu-lar ejection fraction of cardiac function during AMI recovery.Conclusion AMI patients with NT-proBNP peak value exceeding the upper limit should be treated with a series of comprehensive treatment strategies to pro-mote their rehabilitation and improve their long-term prognosis.

Studies have suggested that the nucleus accumbens (NAc) is implicated in the pathophysiology of major depression; however, the regulatory strategy that targets the NAc to achieve an exclusive and outstanding anti-depression benefit has not been elucidated. Here, we identified a specific reduction of cyclic adenosine monophosphate (cAMP) in the subset of dopamine D1 receptor medium spiny neurons (D1-MSNs) in the NAc that promoted stress susceptibility, while the stimulation of cAMP production in NAc D1-MSNs efficiently rescued depression-like behaviors. Ketamine treatment enhanced cAMP both in D1-MSNs and dopamine D2 receptor medium spiny neurons (D2-MSNs) of depressed mice, however, the rapid antidepressant effect of ketamine solely depended on elevating cAMP in NAc D1-MSNs. We discovered that a higher dose of crocin markedly increased cAMP in the NAc and consistently relieved depression 24 h after oral administration, but not a lower dose. The fast onset property of crocin was verified through multicenter studies. Moreover, crocin specifically targeted at D1-MSN cAMP signaling in the NAc to relieve depression and had no effect on D2-MSN. These findings characterize a new strategy to achieve an exclusive and outstanding anti-depression benefit by elevating cAMP in D1-MSNs in the NAc, and provide a potential rapid antidepressant drug candidate, crocin.

Through comprehensive and systematic collection of existing evidence,systematic review adopts clinical epidemiological methods,strictly evaluates the quality of evidence,qualitatively or quantitatively combines research results,and finally provides a reliable basis for solving a focused clinical problem.The number of systematic reviews has increased rapidly.With references to the Checklist,this review discussed the typical issues with current systematic reviews in nursing,and highlighted the crucial components for reporting systematic reviews at every essential step.

Objective To analyze the clinical significance and predictive indicators of N-terminal pro-brain natriuretic peptide(NT-proBNP)levels exceeding the upper limit of detection range in acute myocardial infarction(AMI).Methods A total of 669 pa-tients with AMI were enrolled and divided into two groups based on their peak NT-proBNP levels:exceeding the upper limit of detection range group(n=50)and detectable group(n=619).The two groups were matched using propensity score matching(1∶2).The clinical and laboratory indicators,coronary artery features,and in-hospital prognosis were compared,and multivariate Logistic regression analysis was used to explore early predictive indicators of NT-proBNP exceeding the upper limit of detection range.Results The neutrophil-to-lymphocyte ratio(NLR),high-sensitivity C-reactive protein levels,and fibrinogen levels were higher in the group with NT-proBNP levels exceeding the upper limit of detection range.These findings were consistent after propensity score matching.In terms of in-hospital prognosis,patients in the group with NT-proBNP levels exceeding the upper limit of detection range had a higher propor-tion of Killip class 2 or higher,longer hospital stays,lower left ventricular ejection fraction,and higher incidence of major adverse cardio-vascular and cerebrovascular events.These findings remained consistent after propensity score matching,but there was no statistically sig-nificant difference in peak myocardial enzyme levels between the two groups before and after propensity score matching.Multivariate Logis-tic regression analysis showed that early predictive indicators of NT-proBNP exceeding the upper limit of detection range included higher NLR,lower use of antiplatelet drugs,high fibrinogen levels,left anterior descending branch occlusion,and older age.After propensity score matching,the predictive indicators of NT-proBNP exceeding the upper limit of detection range were right coronary artery occlusion,high NLR,high fibrinogen levels,and left anterior descending branch occlusion.Conclusion AMI patients with NT-proBNP levels ex-ceeding the upper limit of detection range have poorer in-hospital prognosis.NLR and fibrinogen levels on admission can serve as early predictive indicators of NT-proBNP levels exceeding the upper limit of detection range.

Objective To analyze the clinical characteristics and prognosis of patients with coronary slow flow(CSF)or no reflow(CNR)after emergency PCI.Methods A total of 443 elderly STEMI patients who underwent emergency PCI in Department of Cardiology of the First Affilia-ted Hospital of Tsinghua University from January 2017 to August 2023 were recruited,and ac-cording to thrombolysis in myocardial infarction(TIMI)flow grading after operation,they were divided into CSF/CNR group(TIMI grade≤2 flow,n=40)and normal flow(NCF)group(TIMI grade 3 flow,n=403).Logistic regression analysis was used to analyze the risk factors for CSF/CNR in STEMI patients after PCI.The prognosis was analyzed in the two groups.Results The CSF/CNR group had advanced age,longer durations from onset to admission and from onset to balloon opening,higher mortality rate,and larger proportions of chronic heart failure(CHF),type 2 diabetes mellitus(T2DM),pulse rate＞100 times/min,SBP＜100 mm Hg(1 mm Hg=0.133 kPa),Killip grade＞1,left anterior descending artery disease,LVEF＜50％,and using glycopro-tein Ⅱb/Ⅲa inhibitors and intraaortic balloon counterpulsation,but lower male ratio and DBP when compared with the control group(P＜0.05,P＜0.01).Multiple logistic regression analysis revealed that T2DM(OR=1.320,95％CI:0.618-2.123,P=0.046),mean SBP(OR=1.239,95％CI:0.752-1.525,P=0.04)and SBP＜100 mm Hg(OR=1.330,95％CI:0.836-1.675,P=0.013)were independent risk factors,while male was a protective factor(OR=-1.755,95％CI:-2.338--1.171,P=0.002)for CSF/CNR in STEMI patients after PCI.Conclusion T2DM and lower SBP are independent risk factors,while male is a protective factor for CSF/CNR in STEMI patients after emergency PCI.