Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％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)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed 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 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Resection of oral and maxillofacial tumors is often accompanied by the inferior alveolar nerve neurectomy, resulting in abnormal sensation in lower lip. It is generally believed that spontaneous sensory recovery in this nerve injury is difficult. However, during our follow-up, patients with inferior alveolar nerve sacrifice showed different degrees of lower lip sensory recovery. In this study, a prospective cohort study was conducted to demonstrate this phenomenon and analyze the factors influencing sensory recovery. A mental nerve transection model of Thy1-YFP mice and tissue clearing technique were used to explore possible mechanisms in this process. Gene silencing and overexpression experiments were then conducted to detect the changes in cell morphology and molecular markers. In our follow-up, 75% of patients with unilateral inferior alveolar nerve neurectomy had complete sensory recovery of the lower lip 12 months postoperatively. Patients with younger age, malignant tumors, and preservation of ipsilateral buccal and lingual nerves had a shorter recovery time. The buccal nerve collateral sprouting compensation was observed in the lower lip tissue of Thy1-YFP mice. ApoD was demonstrated to be involved in axon growth and peripheral nerve sensory recovery in the animal model. TGF-β inhibited the expression of STAT3 and the transcription of ApoD in Schwann cells through Zfp423. Overall, after sacrificing the inferior alveolar nerve, the collateral compensation of the ipsilateral buccal nerve could innervate the sensation. And this process was regulated by TGF-β-Zfp423-ApoD pathway.
Mice ; Animals ; Lip/innervation* ; Prospective Studies ; Mandibular Nerve/pathology* ; Sensation/physiology* ; Trigeminal Nerve Injuries/pathology*

Objective To observe the effects of 4-week low intensity treadmill exercise on the learning and memory, amino acid levels and the protein expression of protein kinase A ( PKA) , cyclic adenosine monophosphate response element binding protein( CREB) and brain-derived neurotrophic factor(BDNF) in the prefrontal cortex (PFC) of the vascular dementia (VD) rats. Methods Thirty-nine SD rats were randomly allocated to 3 groups, sham group (sham, n= 13) , vascular dementia group (VD, n= 13) and vascular dementia treaded with exercise group (VD + EX, n= 13). Chronic cerebral ischemia model in VD group and VD+EX group rats were established by permanent ligation of bilateral, then VD+EX group rats were submitted to 4-week low intensity treadmill exercise. After exercise, spatial learning and memory ability were evaluated by Moms water maze test ( MWM ) , glutamic ( Glu ) and gamma-aminobutyric acid (GABA) levels in the PFC were measured by high performance liquid chromatography( HPLC) ; the protein expression of PKA, CREB and BDNF in the PFC of rats were detected by Western blotting. Results The result of the MWM showed the average escape latency of rats in the VD group on the 1 -5 days was significantly higer than sham group, the time to first find the original platform was significantly prolonged and the platform crossings decreased significantly ( P < 0 . 01 ) . The average escape latency of rats treated with four-week low intensity treadmill exercise on the 1-5 days was significantly lower than VD group, the time to first find the original platform was significantly shortened and the platform crossings increased significantly(P<0. Of). HPLC and Western blotting detection showed that the levels of Glu and GABA and the protein expression of PKA, CREB and BDNF in the PFC decreased significantly in VD group rats when compared with sham group ( P < 0.01 ) . Glu level and the protein expression of PKA, CREB and BDNF in the PFC of rats increased significantly ( P < 0 . 05) in VD + EX group rats when compared with VD group rats, but GABA level was not significant difference ( P > 0. 05 ) between the two groups. Conclusion Four-week low-intensity running exercise improves the learning and memory ability of VD rats through enhancing the Glu level and activating PKA-CREB-BDNF signaling in the PFC of rats.

Objective To examine the effect of estradiol (E2) treatment on ovariectomy (OVX) induced depressive-like behavior and possible mechanism by measuring inflammatory biomarkers levels oi interleukin-6 (IL-6) and tumor necrosis tactor-(x (TNF-ot) and brain-derived neurotrophic factor (BDNF) expression in amygdaia nucleus. Methods Thirty nine healthy aduit 缶male SD rats were randomly divided into three groups : sham operation group (SO), ovariectomized group (OVX) and ovariectomized estradiol treatment group (OVX + E2). After 6 weeks of E2 treatment, depressive like behavior was evaluated by opening field test (OFT) and sugar water preference test (SPT). The levels of inflammatory factors IL-6 and TNF-a in amygdala were measured by ELESA, and the expression of BDNF in rat amygdala was detected by immunohistochemical staining. Results The result of the SPT showed that OVX significantly decreased the sugar intake and sugar preference rate of rats, and E2 treatment significantly increased sugar water intake and sugar water preference rate of rats. The result of the OFT showed that OVX significantly decreased the numbers of crossing and rearing of rats, and reduced the time spent in the centre ; E2 treatment significantly increased the numbers of crossing and rearing of rats, and prolonged the time spent in the centre. ELESA and immunohistochemical analysis found the levels of IL-6 and TNF-a in amygdala increased significantly, while the average absorbance (AA) of BDNF in the amygdala reduced significantly (P<0.01 respectively) of rats in OVX group when compared with the SO group. And the levels of IL-6 and TNF-a in amygdala decreased significantly (P<0.01 respectively), while the A4 of BDNF increased significantly (P< 0.05) in the amygdala of rats in the OVX+EX group when compared with the OVX group. The difference was statistically significant. Conclusion E2 treatment improved depression-like behavior of OVX rats is partly due to increased antiinflammatory and activated the BDNF expression in amygdaloid nucleus, thus enhancing the neuroprotective effect of OVX rats.

To probe the effects of Trichinella spiralis muscle larval somatic proteins on small cell lung cancer H446 cells and the possible mechanism of anti-tumor,H446 cells were culture with 0.2 mg/mL,0.4 mg/mL,0.6 mg/mL,0.8 mg/mL,1.0 mg/mL,and 1.2 mg/mL somatic proteins respectively.The experimental group was set and no dosing as control group.MTT colorimetric assay was used to test the effects of T.spiralis muscle larval somatic proteins on the proliferative activity of H446 cells.We used flow cytometry (FCM) to test the influence of T.spiralis muscle larval somatic proteins induced H446 cells apoptosis.The real-time PCR and Western blot methods were used to detect the expression of Cyt-C and apoptotic protease activating factor 1(Apaf-1) mRNA and protein.The MTT colorimetric assay showed that T.spiralis muscle larval somatic proteins could inhibit the proliferation of H446 cells;the flow cytometry showed that polypide proteins acted on H446 cells after 24 h appeared an obvious effect on promoting apoptosis.Results of real-time PCR and Western blot analysis indicated that compared with the control group,Cyt-C and Apaf-1 showed up-regulated expression.T.spiralis muscle larval somatic proteins could inhibit proliferation activity and induce the apoptosis of H446 cells,and its effects may be related to up-regulated expression of Cyt-C and Apaf-1.

Objective To investigate the value of shear wave elastography(SWE)to early predict clinical efficacy of breast cancer neoadjuvant chemotherapy(NAC).Methods Fifty-three patients(55 lesions)with breast cancer who underwent NAC were enrolled in this study.SWE was performed at baseline and after the end of 2,4,6 cycles of NAC.According to the postoperative pathological results,the lesions were divided into major pathologic response group and minor pathologic response group.The maximum diameter of the lesions between the baseline and the end of the last cycle of the two groups were measured and the maximum diameter changes(ΔDmax)of the two groups were compared.The maximum elastic modulus(Emax)and the maximum elastic modulus changes(ΔEmax)of the two groups were measured and compared at baseline and after the end of 2,4,6 cycles of NAC.The ROC curves of ΔEmax at the end of 2 and 4 cycles were used to evaluate the predictive value of NAC response.Results The ΔDmax of the major pathologic response group[(64.82±21.06)%]was higher than that of the minor pathologic response group[(26.49±26.1 1)%,P <0.001].With the prolongation of NAC,the values of Emax were significantly decreased in the two groups,but the decreasing degrees were different.The Emax was significantly decreased at the end of 2 cycles in the major pathologic response group(P <0.05),however, at the end of 4 cycles in minor pathologic response group(P <0.05).The value of ΔEmax in the major pathologic response group was higher than that in the minor pathologic response group in every cycle significantly(all P <0.05).The ΔEmax threshold of the 2 cycles for predicting the NAC response was 26.1%(81.8% of sensitivity,75% of specificity),while the threshold of the 4 cycles was 35.5%(87.9%of sensitivity,83.3% of specificity),there was no significant difference between the areas under the two curves(P =0.264).Conclusions The value of ΔEmax in breast cancer lesions can predict the efficacy of NAC early.SWE can provide a valuable complement for two-dimensional ultrasound in the evaluation of NAC efficacy in breast cancer.

Objective To evaluate the clinical efficacy and safety of tri-mebutine combined with Shugan granule in the treatment of functional dyspepsia.Methods A total of 84 patients with functional dyspepsia were randomly divided into control group ( n=42 ) and treatment group ( n=42 ).Control group was treated with trimebutine 0.2 g, tid for 4 weeks.Treatment group was treated with trimebutine 0.2 g, tid and Shu-gan granule 3 g, bid for 4 weeks.The clinical symptom scores, self -rating anxiety scale ( SAS ) and self -rating depression scale ( SDS ) scores, and incidence of adverse drug reactions were compared between the two groups.Results After treatment, the clinical symptom scores, SAS and SDS scores in treatment group were significantly lower than those in control group( all P<0.05).The incidence of adverse drug reactions in two groups has no significant difference( P>0.05).Conclusion The combined therapy of trimebutine and Shugan granule can significantly improve the clinical symptoms and the states of anxiety and depression without increasing of the incidence of adverse drug reactions.

Anterolateral thigh flap is perfect for reconstructing maxillofacial soft tissue defects. This tissue has been widely used by clinicians, but often causes operation difficulties because of vascular variation. In this paper, we report a case where anteromedial thigh was used as new donor site when the vascular anatomic variation of anterolateral thigh perforator flap induced a failure in the flap harvest. Moreover, this paper discusses the anatomy and application of anteromedial thigh flap.
Humans ; Maxillofacial Abnormalities ; surgery ; Perforator Flap ; Reconstructive Surgical Procedures ; methods ; Thigh ; surgery

Objective To compare the mRNA expressions of interleukin (IL)-17 and IL-23 in peripheral blood of patients with psoriasis vulgaris versus healthy individuals,assess the relationship of these parameters with psoriasis area and severity index (PASI) score,and to investigate the therapeutic mechanisms of total glucosides of peony (TGP) for psoriasis vulgaris.Methods Fifty patients with psoriasis vulgaris and 40 healthy individuals were enrolled in this study.Of these patients,42 were treated with TGP of 600-900 mg twice a day for 8 weeks.Blood samples were obtained from all the healthy individuals,50 patients before treatment,42 patients after 4-week treatment,and 23 patients after 8-week treatment.Real-time fluorescence-based quantitative reverse transcription PCR (RT-PCR) was used to determine the mRNA expression levels of IL-17 and IL-23 in the blood samples.The severity of psoriasis was evaluated using PASI score before and after the treatment.Statistical analysis was done by t test,rank sum test,and Pearson correlation analysis using the SPSS16.0 software.Results The IL-17 and IL-23 mRNA expression levels (given in △Ct value) in the patients before treatment were significantly higher than those in the healthy controls (IL-17,-5.32 ± 0.80 vs.2.79 ± 0.76,t =47.71,P ＜ 0.05; IL-23,-5.43 ± 0.68 vs.-3.77 ± 0.86,t =10.38,P ＜ 0.05),and positively correlated with the PASI score (r =0.61,0.52 respectively,both P ＜ 0.05).A significant decrease was observed in the mRNA expression levels of IL-17 and IL-23 as well as PASI score in the 42 patients after 4-week treatment with TGP compared with those before treatment(IL-17,-2.24 ± 0.61 vs.-5.30 ± 0.78,t =20.40,P ＜ 0.05; IL-23,-1.97 ± 0.74 vs.-5.44 ± 0.68,t =21.69,P ＜ 0.05; PASI,5.8 ± 2.7 vs.9.4 ± 4.2,t =4.68,P ＜ 0.05),and in the 23 patients after 8-week treatment compared with those after 4-wek treatment(IL-17,-1.51 ± 0.78 vs.-2.21 ± 0.59,t =3.50,P ＜ 0.05; IL-23,-1.27 ± 0.81 vs.-1.89 ± 0.72,t =2.70,P＜ 0.05; PASI,3.8 ± 1.8 vs.7.3 ± 2.5,t =5.47,P＜ 0.05).Conclusions It seems that both IL-17 and IL-23 are involved in the pathogenesis of psoriasis vulgaris,and TGP treatment can reduce the mRNA expression levels of IL-17 and IL-23 as well as PASI score in patients with psoriasis vulgaris.

10.3969/j.issn.1007-3969.2013.05.003