Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2023.Methods Clinical isolates collected from 73 hospitals across China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2023 Clinical & Laboratory Standards Institute (CLSI) breakpoints.Results A total of 445199 clinical isolates were collected in 2023,of which 29.0％ were gram-positive and 71.0％ were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species (excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi) (MRSA,MRSE and MRCNS) was 29.6％,81.9％ and 78.5％,respectively.Methicillin-resistant strains showed significantly higher resistance rates to most antimicrobial agents than methicillin-susceptible strains (MSSA,MSSE and MSCNS).Overall,92.9％ of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 91.4％ of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis had significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 93.1％ in the isolates from children and and 95.9％ in the isolates from adults.The resistance rate to carbapenems was lower than 15.0％ for most Enterobacterales species except for Klebsiella,22.5％ and 23.6％ of which were resistant to imipenem and meropenem,respectively .Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.6％ to 10.0％.The resistance rate to imipenem and meropenem was 21.9％ and 17.4％ for Pseudomonas aeruginosa,respectively,and 67.5％ and 68.1％ for Acinetobacter baumannii,respectively.Conclusions Increasing resistance to the commonly used antimicrobial agents is still observed in clinical bacterial isolates.However,the prevalence of important crabapenem-resistant organisms such as crabapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a slightly decreasing trend.This finding suggests that strengthening bacterial resistance surveillance and multidisciplinary linkage are important for preventing the occurrence and development of bacterial resistance.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2023.Methods Clinical isolates collected from 73 hospitals across China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2023 Clinical & Laboratory Standards Institute (CLSI) breakpoints.Results A total of 445199 clinical isolates were collected in 2023,of which 29.0％ were gram-positive and 71.0％ were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species (excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi) (MRSA,MRSE and MRCNS) was 29.6％,81.9％ and 78.5％,respectively.Methicillin-resistant strains showed significantly higher resistance rates to most antimicrobial agents than methicillin-susceptible strains (MSSA,MSSE and MSCNS).Overall,92.9％ of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 91.4％ of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis had significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 93.1％ in the isolates from children and and 95.9％ in the isolates from adults.The resistance rate to carbapenems was lower than 15.0％ for most Enterobacterales species except for Klebsiella,22.5％ and 23.6％ of which were resistant to imipenem and meropenem,respectively .Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.6％ to 10.0％.The resistance rate to imipenem and meropenem was 21.9％ and 17.4％ for Pseudomonas aeruginosa,respectively,and 67.5％ and 68.1％ for Acinetobacter baumannii,respectively.Conclusions Increasing resistance to the commonly used antimicrobial agents is still observed in clinical bacterial isolates.However,the prevalence of important crabapenem-resistant organisms such as crabapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a slightly decreasing trend.This finding suggests that strengthening bacterial resistance surveillance and multidisciplinary linkage are important for preventing the occurrence and development of bacterial resistance.

【Objective】 To develop a mobile software application named " Component Assistant" and test for its performance in practical work, so as to address the difficulties and problems encountered during the management process of blood component preparation, such as communication and coordination in the workflow, personnel scheduling and workload arrangements. 【Methods】 The software was developed based on the daily work requirements and processes using Java language, and foreground-background separation technologies were employed to provide secure and reliable data support. 【Results】 The results of practical work verification showed that through this software, component preparation managers were able to real-time monitor blood collection situations, blood transfusion details, manage inventory levels, and summarize and review the details of the preparation process. Comparison of the usage sequence of this software, the average amount of blood prepared of employees has increased(198 bloodbag, /M), the workload of employees has increased(3.5, /M) and the rest time has been shortened(1 h, /M). 【Conclusion】 The innovation of this software lies in providing effective data support for matching the workload and personnel in component preparation operations, meeting the needs of blood component preparation management, and greatly improving work efficiency in this field.

ObjectiveTo compare the four preparation methods of Rehmanniae Radix juice described in ancient literature and find the method that is most suitable for the preparation of Rehmanniae Radix juice used in Baihe Dihuangtang. MethodThe ancient medical books record four methods for preparing Rehmanniae Radix juice： crushing fresh Rehmanniae Radix for juice， steaming fresh Rehmanniae Radix for juice， boiling fresh Rehmanniae Radix for juice， and boiling dry Rehmanniae Radix for juice. Ultra performance liquid chromatography-quadrupole time-of-flight mass spectrometry （UPLC-Q-TOF-MS） was employed to detect the compounds in the four juice samples， followed by principal component analysis （PCA）. Result① Totally 27 compounds were identified in the juice samples， including 10 iridoid glycosides， 14 phenylethanoid glycosides， 2 phenolic acids， and 1 irisone. Among them， 15 common compounds were shared by the four juice samples， including 7 iridoid glycosides， 7 phenylethanoid glycosides， and 1 phenolic acid. ② Five common compounds in the four juice samples can be matched with the reference standards， which were catalpol， aucubin， rehmannioside D， ajugol， and purpureaside C. ③ Verbascoside and isoacteoside were not detected in the juice prepared by crushing fresh Rehmanniae Radix， while it was detected in the other three juice samples， which indicated that the two components were produced after heating rather than being the original components in fresh Rehmanniae Radix. ④ The comparison of the ion fragments demonstrated that verbascoside was produced from purpureaside C after the cleavage of the glycosidic bond and removal of a molecule of mannose. ⑤ Isoacteoside could be isomerized from verbascoside， and its relative content increased with the extension of heating time. However， the relative content of verbascoside and purpureaside C did not decrease significantly. Therefore， it was hypothesized that purpureaside C was produced from its upstream component. ConclusionThe juice prepared by crushing fresh Rehmanniae Radix has the chemical composition significantly different from the juice samples prepared with the other 3 methods， while the latter 3 juice samples had similar chemical composition. Although all the four methods can be used， it is more suitable to prepare Rehmanniae Radix juice by steaming fresh Rehmanniae Radix， boiling fresh Rehmanniae Radix， and boiling dry Rehmanniae Radix.

Objective: To investigate the efficacy and safety of the new investigational drug pegylated interferon α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 µg/week) combined with ribavirin in the treatment of patients with genotype 1/6 chronic hepatitis C (CHC), with standard-dose Peg-IFN-α-2a combined with ribavirin as a positive control. Methods: A multicenter, randomized, open-label, and positive-controlled phase III clinical trial was performed. Eligible patients with genotype 1/6 CHC were screened out and randomly divided into Peg-IFN-α-2b(Y shape, 40kD) group and Peg-IFN-α-2a group at a ratio of 2:1. The patients in both groups were given oral ribavirin for 48 weeks in addition and then followed up for 24 weeks after drug withdrawal. Abbott Real Time HCV Genotype II was used to determine HCV genotype, and Cobas TaqMan quantitative real-time PCR was used to measure HCV RNA level at 0, 4, 12, 24, 48, and 72 weeks. Adverse events were recorded in detail. The primary efficacy endpoint was sustained virological response (SVR), and a non-inferiority test was also performed. Results: A total of 561 patients with genotype 1/6 CHC were enrolled, among whom 529 received treatment; 90.9% of these patients had genotype 1 CHC. The data of the full analysis set showed that SVR rate was 69.80% (95% CI 65.00%-74.60%) in the trial group and 74.16% (95% CI 67.73%-80.59%) in the control group (P = 0.297 0). The data of the per protocol set (PPS) showed that SVR rate was 80.63% (95% CI 76.04%-85.23%) in the trial group and 81.33% (95% CI 75.10%-87.57%) in the control group (P = 0.849 8), and the 95% CI of rate difference conformed to the non-inferiority standard. The analysis of the PPS population showed that of all subjects, 47.9% achieved rapid virologic response, with a positive predictive value of 93.8%. The incidence rate of adverse events was 96.30% in the trial group and 94.94% in the control group, and the incidence rate of serious adverse events was 5.13% in the trail group and 5.06% in the control group. Conclusion In the regimen of Peg-IFN-α combined with ribavirin for the treatment of genotype 1/6 CHC, the new investigational drug Peg-IFN-α-2b(Y shape, 40 kD) has comparable clinical effect and safety to the control drug Peg-IFN-α-2a.

Objective: To investigate the clinical effect and safety of long-acting pegylated interferon-α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 μg/week) in the treatment of HBeAg-positive chronic hepatitis B (CHB) patients, with standard-dose Peg-IFN-α-2a as positive control. Methods: This study was a multicenter, randomized, open-label, and positive-controlled phase III clinical trial. Eligible HBeAg-positive CHB patients were screened out and randomized to Peg-IFN-α-2b (Y shape, 40 kD) trial group and Peg-IFN-α-2a control group at a ratio of 2:1. The course of treatment was 48 weeks and the patients were followed up for 24 weeks after drug withdrawal. Plasma samples were collected at screening, baseline, and 12, 24, 36, 48, 60, and 72 weeks for centralized detection. COBAS® Ampliprep/COBAS® TaqMan® HBV Test was used to measure HBV DNA level by quantitative real-time PCR. Electrochemiluminescence immunoassay with Elecsys kit was used to measure HBV markers (HBsAg, anti-HBs, HBeAg, anti-HBe). Adverse events were recorded in detail. The primary outcome measure was HBeAg seroconversion rate after the 24-week follow-up, and non-inferiority was also tested. The difference in HBeAg seroconversion rate after treatment between the trial group and the control group and two-sided confidence interval (CI) were calculated, and non-inferiority was demonstrated if the lower limit of 95% CI was > -10%. The t-test, chi-square test, or rank sum test was used according to the types and features of data. Results: A total of 855 HBeAg-positive CHB patients were enrolled and 820 of them received treatment (538 in the trial group and 282 in the control group). The data of the full analysis set showed that HBeAg seroconversion rate at week 72 was 27.32% in the trial group and 22.70% in the control group with a rate difference of 4.63% (95% CI -1.54% to 10.80%, P = 0.1493). The data of the per-protocol set showed that HBeAg seroconversion rate at week 72 was 30.75% in the trial group and 27.14% in the control group with a rate difference of 3.61% (95% CI -3.87% to 11.09%, P = 0.3436). 95% CI met the non-inferiority criteria, and the trial group was non-inferior to the control group. The two groups had similar incidence rates of adverse events, serious adverse events, and common adverse events. Conclusion In Peg-IFN-α regimen for HBeAg-positive CHB patients, the new drug Peg-IFN-α-2b (Y shape, 40 kD) has comparable effect and safety to the control drug Peg-IFN-α-2a.

Objective To observe the effect of hyperbaric oxygen (HBO) combined with fasudil hydrochloride on the nerve function of the patients after embolization in the treatment of intracranial aneurysm.Methods Clinical data of 130 patients with intracranial aneurysm treated in our hospital from June 2011 to June 2016 were recruited as research subjects and they were divided into the control group (n =55) and the observation group (n =75) in accordance with different treatment methods.The patients of the control group were treated with nimodipine in addition to routine therapy,while the patients of the observation group were supplemented with HBO on the basis of the treatment received by the control group.Brain edema scores both before and after treatment were compared between the 2 groups.Analyses were also made on the following indexes:Glasgow coma scale (GCS) and Glasgow outcome scale (GOS) grade,middle cerebral artery blood (MCA) flow velocity and cerebral vasospasm (CVS),neural function defect (NFD)scores,Barthel index scores,incidence of cerebral infarction at day 30 after surgery,as well as incidence of adverse reactions.Results There was statistical significance in the brain edema scores,NFD scores and Barthel scores of the observation group,as compared with those before treatment (P ＜ 0.01).MCA and CVS blood flow velocity was significantly lower than that before treatment (P ＜ 0.01),and that of the observation group was obviously lower than that of the control group (P ＜ 0.05).The GCS scores were significantly lower than those before treatment [(14.14±1.88) vs (8.87±1.06),(11.17±1.71) vs (8.71±1.17),P＜0.01].Three months after treatment,GOS grade of the observation group was obviously superior to that of the control group (F =9.625,P ＜0.01).The rate of cerebral infarction in the patients of the observation group was significantly lower than that of the control group (6.67％ vs 18.18％,P ＜ 0.05),and statistical significance could be noted,when comparisons were made between the 2 groups (P ＜ 0.05).Conclusions HBO combined with fasudil hydrochloride in the treatment of intracranial aneurysm after embolization could significantly improve the neurological function,enhance cerebral artery blood flow velocity and promote recovery of daily activities of the patients.

Objective To observe the effects of hyperbaric oxygen (HBO) combined with minimally invasive catheter puncture in the treatment of hypertensive intracerebral hemorrhage (HICH).Methods One hundred and twenty-two cases of HICH were divided into the observation group (63 cases) and the control group (59 cases),in accordance with treatment methods.The control group received Edaravone injection and ganglioside injection,in addition to routine therapy,while the observation group received the same treatment as the control group plus HBO.Then,changes in the levels of intracranial pressure (ICP),mean arterial pressure (MAP),neurological deficit (NIHSS) scores,daily life ability scale (ADL) classification,stroke scale scores (SSSs),modified Rankin scale (mRS) scores,serum malondialdehyde (MDA),superoxide dismutase enzyme (SOD) and glutathione peroxidase (GSH-px) were compared between the 2 groups.Results (1) After treatment,ICP levels at day 7 for the patients in the 2 groups were all significantly higher than ICP levels at day 1 and day 14 (P ＜ 0.01),and the ICP levels of the observation group at day 7 and day 14 were significantly higher than those of the control group (P ＜ 0.05),and no statistical significance could be seen in MAP levels of the 2 groups at different time points (P ＞ 0.05).(2) There was statistical significance in the levels of MDA,SOD and GSH-px in the patients of the 2 groups at day 14 after treatment,as compared with those before treatment (P ＜ 0.05 or P ＜ 0.01).(3) NIHSS scores of the patients in the 2 groups after treatment were significantly lower than those before treatment at day 7,14 and 21 (P ＜ 0.01).NIHSS scores of the patients in the observation group at day 7,14 and 21 after surgery were significantly lower than those in the control group (P ＜ 0.05).(4) Clinical follow-ups after 3 months of treatment indicated that recovery rate of ADL classification of the observation group was obviously higher than that of the control group(P ＜ 0.01).(5) Statistical significance could be noted in the scores of mRS and SSS at day 20,30 and 90 for the patients of the 2 groups,as compared with those before treatment (P ＜ 0.05 or P ＜ 0.01),and at day 90 after treatment,statistical significance could also be noticed in the scores of mRA and SSS scores,when comparison were made between the patients of the 2 groups (P ＜ 0.05).Conclusions Early HBO combined with minimally invasive catheter puncture plus routine therapy could improve neurological functions of the patients with HICH and the quality of daily life.For this reason it was worth further clinical promotion.

Objective To observe the effect of hyperbaric oxygen (HBO) combined with fasudil hydrochloride on the nerve function of the patients after embolization in the treatment of intracranial aneurysm.Methods Clinical data of 130 patients with intracranial aneurysm treated in our hospital from June 2011 to June 2016 were recruited as research subjects and they were divided into the control group (n =55) and the observation group (n =75) in accordance with different treatment methods.The patients of the control group were treated with nimodipine in addition to routine therapy,while the patients of the observation group were supplemented with HBO on the basis of the treatment received by the control group.Brain edema scores both before and after treatment were compared between the 2 groups.Analyses were also made on the following indexes:Glasgow coma scale (GCS) and Glasgow outcome scale (GOS) grade,middle cerebral artery blood (MCA) flow velocity and cerebral vasospasm (CVS),neural function defect (NFD)scores,Barthel index scores,incidence of cerebral infarction at day 30 after surgery,as well as incidence of adverse reactions.Results There was statistical significance in the brain edema scores,NFD scores and Barthel scores of the observation group,as compared with those before treatment (P ＜ 0.01).MCA and CVS blood flow velocity was significantly lower than that before treatment (P ＜ 0.01),and that of the observation group was obviously lower than that of the control group (P ＜ 0.05).The GCS scores were significantly lower than those before treatment [(14.14±1.88) vs (8.87±1.06),(11.17±1.71) vs (8.71±1.17),P＜0.01].Three months after treatment,GOS grade of the observation group was obviously superior to that of the control group (F =9.625,P ＜0.01).The rate of cerebral infarction in the patients of the observation group was significantly lower than that of the control group (6.67％ vs 18.18％,P ＜ 0.05),and statistical significance could be noted,when comparisons were made between the 2 groups (P ＜ 0.05).Conclusions HBO combined with fasudil hydrochloride in the treatment of intracranial aneurysm after embolization could significantly improve the neurological function,enhance cerebral artery blood flow velocity and promote recovery of daily activities of the patients.

Objective To observe the effects of hyperbaric oxygen (HBO) combined with minimally invasive catheter puncture in the treatment of hypertensive intracerebral hemorrhage (HICH).Methods One hundred and twenty-two cases of HICH were divided into the observation group (63 cases) and the control group (59 cases),in accordance with treatment methods.The control group received Edaravone injection and ganglioside injection,in addition to routine therapy,while the observation group received the same treatment as the control group plus HBO.Then,changes in the levels of intracranial pressure (ICP),mean arterial pressure (MAP),neurological deficit (NIHSS) scores,daily life ability scale (ADL) classification,stroke scale scores (SSSs),modified Rankin scale (mRS) scores,serum malondialdehyde (MDA),superoxide dismutase enzyme (SOD) and glutathione peroxidase (GSH-px) were compared between the 2 groups.Results (1) After treatment,ICP levels at day 7 for the patients in the 2 groups were all significantly higher than ICP levels at day 1 and day 14 (P ＜ 0.01),and the ICP levels of the observation group at day 7 and day 14 were significantly higher than those of the control group (P ＜ 0.05),and no statistical significance could be seen in MAP levels of the 2 groups at different time points (P ＞ 0.05).(2) There was statistical significance in the levels of MDA,SOD and GSH-px in the patients of the 2 groups at day 14 after treatment,as compared with those before treatment (P ＜ 0.05 or P ＜ 0.01).(3) NIHSS scores of the patients in the 2 groups after treatment were significantly lower than those before treatment at day 7,14 and 21 (P ＜ 0.01).NIHSS scores of the patients in the observation group at day 7,14 and 21 after surgery were significantly lower than those in the control group (P ＜ 0.05).(4) Clinical follow-ups after 3 months of treatment indicated that recovery rate of ADL classification of the observation group was obviously higher than that of the control group(P ＜ 0.01).(5) Statistical significance could be noted in the scores of mRS and SSS at day 20,30 and 90 for the patients of the 2 groups,as compared with those before treatment (P ＜ 0.05 or P ＜ 0.01),and at day 90 after treatment,statistical significance could also be noticed in the scores of mRA and SSS scores,when comparison were made between the patients of the 2 groups (P ＜ 0.05).Conclusions Early HBO combined with minimally invasive catheter puncture plus routine therapy could improve neurological functions of the patients with HICH and the quality of daily life.For this reason it was worth further clinical promotion.