Objective To understand the distribution and changing resistance profiles of clinical isolates of Enterococcus in hospitals across China from 2015 to 2021.Methods Antimicrobial susceptibility testing was conducted for the clinical isolates of Enterococcus according to the unified protocol of CHINET program by automated systems,Kirby-Bauer method,or E-test strip.The results were interpreted according to the Clinical & Laboratory Standards Institute(CLSI)breakpoints in 2021.WHONET 5.6 software was used for statistical analysis.Results A total of 124 565 strains of Enterococcus were isolated during the 7-year period,mainly including Enterococcus faecalis(50.7％)and Enterococcus faecalis(41.5％).The strains were mainly isolated from urinary tract specimens(46.9％±2.6％),and primarily from the patients in the department of internal medicine,surgery and ICU.E.faecium and E.faecalis strains showed low level resistance rate to vancomycin,teicoplanin and linezolid(≤3.6％).The prevalence of vancomycin-resistant E.faecalis and E.faecium was 0.1％and 1.3％,respectively.The prevalence of linezolid-resistant E.faecalis increased from 0.7％in 2015 to 3.4％in 2021,while the prevalence of linezolid-resistant E.faecium was 0.3％.Conclusions The clinical isolates of Enterococcus were still highly susceptible to vancomycin,teicoplanin,and linezolid,evidenced by a low resistance rate.However,the prevalence of linezolid-resistant E.faecalis was increasing during the 7-year period.It is necessary to strengthen antimicrobial resistance surveillance to effectively identify the emergence of antibiotic-resistant bacteria and curb the spread of resistant pathogens.

BackgroundSuicidal behavior in adolescence and early adulthood is a major public health concern， and suicide attempts are found to be associated with reasons for living and self-control， whereas there remains a striking lack of empirical research exploring the association among the three in college students. ObjectiveTo explore the relationship among suicide attempts， reasons for living and self-control， and to inform targeted efforts to prevent the development of suicidal behavior. MethodsFrom April to May 2023， a sample of 775 college students from 10 colleges and universities in Shaanxi province， Sichuan province and Chongqing municipality were selected using random sampling method. All students were subjected to complete Self-Control Scale （SCS）， the Reasons for Living Inventory for Adolescents （RFL-A）， and the self-administered Suicide Attempt Questionnaire. Spearman correlation analysis was utilized to examine the correlation among the above scales in students， and mediation analysis was performed using Mplus 8.3. ResultsA total of 738 college students （95.32%） completed the effective questionnaire survey.Suicide attempts were detected in 99 college students （13.41%）. SCS score was positively correlated with RFL-A score （r=0.329， P<0.01）， and SCS score and RFL-A score were both negatively correlated with the risk of suicide attempts （r=-0.194， -0.285， P<0.01）. The indirect mediation effect value of self-control on the relationship between reasons for living and suicide attempts was -0.059 （95% CI： -0.105~-0.018）， accounting for 11.07% of the total effect. There was a gender difference in the mediating effect of self-control， among which the effect was significant in male group， with an indirect effect value of -0.089 （95% CI： -0.163~-0.030） and accounting for 15.72% of the total effect， whereas the mediating effect was not significant in female group （95% CI： -0.407~0.115）. ConclusionReasons for living can negatively predict suicide attempts among college students， and self-control may play a mediating role in the relationship between reasons for living and suicide attempts among college students， and the mediating effect of self-control appears to be statistically significant only in male but not in female students.

To develop a caregiver parenting behavior scale for children aged 2 to 6 years, and to verify its reliability and validity. This study recruited 1 350 caregivers of children aged 2 to 6 years. The item discrimination analysis and exploratory factor analysis were used to analyze the structure, dimensions and items of the scale. Homogeneity reliability, split-half reliability and test-retest reliability were used to analyze the reliability of the scale. Content validity and construct validity were used to analyze the validity of the scale. The results showed that the final scale contained 7 dimensions and 45 items. Cronbach's α coefficient of the total scale was 0.945; the coefficient of split half was 0.899; the test-retest reliability analysis showed that the correlation coefficients between the two tests were 0.893 (total score), 0.854 (social), 0.832 (language), 0.871 (gross motor), 0.893 (fine motor), 0.862 (cognitive), 0.832 (self-care), and 0.872 (sensory). The content validity analysis was carried out by two rounds of expert argumentation using Delphi expert consultation method. The Kendall coefficient of the items score in two rounds of Delphi expert consultation was 0.813 (P<0.01). The structure validity analysis showed that there were significant correlations between each dimension and the total scale, also between each dimension of the scale, and the extracted average variance values of each dimension was greater than the correlation coefficients between this dimension and other dimensions. In conclusion, the reliability and validity of the scale are qualified. It can be used as a tool to evaluate and guide the parenting behavior of caregivers of children aged 2 to 6 years.
Humans ; Child ; Caregivers/psychology* ; Reproducibility of Results ; Parenting ; Surveys and Questionnaires ; Factor Analysis, Statistical ; Psychometrics/methods*

Healthy birth and child development are the prerequisite for improving the overall quality of the population. However, premature ovarian failure(POF) threatens the reproductive health of women. The incidence of this disease has been on the rise, and it tends to occur in the young. The causes are complex, involving genetics, autoimmune, infectious and iatrogenic factors, but most of the causes remain unclear. At the moment, hormone replacement therapy and assisted reproductive technology are the main clinical approaches. According to traditional Chinese medicine(TCM), kidney deficiency and blood stasis are one of the major causes of POF, and TCM with the effects of tonifying kidney and activating blood has a definite effect. Through clinical trials, TCM prescriptions for POF have excellent therapeutic effect as a result of multi-target regulation and slight toxicity. In particular, they have no obvious side effects. A large number of studies have shown that the kidney-tonifying and blood-activating TCM can regulate the neuroendocrine function of hypothalamic-pituitary-ovarian axis, improve ovarian hemodynamics and microcirculation, reduce the apoptosis of granulosa cells, alleviate oxidative stress injury, and modulate immunologic balance. The mechanism is that it regulates the phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt), vascular endothelial growth factor(VEGF), transforming growth factor(TGF)-β/Smads, nuclear factor E2-related factor 2(Nrf2)/antioxidant response element(ARE), and nuclear factor-kappa B(NF-κB) signaling pathways. This article summarized the pathological mechanisms of tonifying kidney and activating blood TCM in the prevention and treatment of POF and explored the biological basis of its multi-pathway and multi-target characteristics in the treatment of this disease. As a result, this study is expected to serve as a reference for the treatment of POF with the tonifying kidney and activating blood therapy.
Child ; Humans ; Female ; Primary Ovarian Insufficiency/drug therapy* ; Phosphatidylinositol 3-Kinases/metabolism* ; Vascular Endothelial Growth Factor A ; Medicine, Chinese Traditional ; NF-kappa B ; Kidney

Hypoxia inducible factor-1α (HIF-1α), as a hypoxia inducible factor, affects women's reproductive function by regulating the development and excretion of follicles. HIF-1α induces glycolysis and autophagy in the granule cells by promoting oocyte development, regulating the secretion of related angiogenic factors, and improving follicle maturity. In addition, HIF-1α promotes the process of luteinization of follicular vesicles, maintains luteal function, and finally completes physiological luteal atrophy through cumulative oxidative stress. Dysfunction of HIF-1α will cause a series of pathological consequences, such as angiogenesis defect, energy metabolism abnormality, excessive oxidative stress and dysregulated autophagy and apoptosis, resulting in ovulation problem and infertility. This article summarizes the previous studies on the regulation of follicle development and excretion and maintenance of luteal function and structural atrophy by HIF-1α. We also describe the effective intervention mechanism of related drugs or bioactive ingredients on follicular dysplasia and ovulation disorders through HIF-1α, in order to provide a systematic and in-depth insights for solving ovulation disorder infertility.
Female ; Humans ; Atrophy/metabolism* ; Hypoxia ; Hypoxia-Inducible Factor 1, alpha Subunit/metabolism* ; Infertility/metabolism* ; Ovarian Follicle ; Ovulation

Objective :To study influence of cardiac rehabilitation combined routine treatment on cardiac function and ECG in patients with ischemic cardiomyopathy (ICM).Methods :A total of 108 ICM patients treated in our hospital from Jul 2013 to May 2017 were randomly and equally divided into routine treatment group and cardiac rehabilitation group (received cardiac rehabilitation therapy based on routine treatment group ) ,both groups were treated for eight weeks .LVEF ,left ventricular fractional shortening (LVFS) ,QT dispersion (QTd) ,T peak‐T end interval (Tp‐e) before and after treatment ,and therapeutic effect were observed and compared between two groups .Results :Total effective rate of cardiac rehabilitation group was significantly higher than that of routine treatment group (87. 0%vs.75.9%) , P＝0.043. Compared with before treatment ,there were significant rise in LVEF and LVFS ,and sig‐nificant reductions in QTd and Tp‐e in two groups after eight‐week treatment (except Tp‐e of routine treatment group) , P＜0.05 or ＜0.01. Compared with routine treatment group after treatment ,there were significant rise in LVEF [(42.3 ± 5.8)% vs.(49.8 ± 6.5)%] and LVFS [(25.6 ± 6.1)% vs.(35.2 ± 6. 9)%] ,and significant reduc‐tions in QTd [ (52. 3 ± 6. 3) ms vs .(45. 2 ± 7. 1) ms] and Tp‐e [ (129.7 ± 12. 5) ms vs.(118. 5 ± 13.0) ms] in car‐diac rehabilitation group ,P＝0.001 all.Conclusion :Cardiac rehabilitation combined routine treatment possesses sig‐nificant therapeutic effect on ICM patients .It can significantly improve cardiac function .

Objective: To summarize the clinical characteristics, treatment response and prognostic factors of rhabdomyosarcoma (RMS) in children. Methods: The clinical characteristics such as age at diagnosis, primary tumor site, tumor size, pathological type, clinical stage, and risk grouping of 213 RMS patients (140 males and 73 females) treated in Hematology Oncology Center of Beijing Children′s Hospital, Capital Medical University, from May 2006 to June 2018 were analyzed retrospectively. The clinical characteristics, overall survival (OS), event free survival (EFS) and prognostic factors of children treated with the Beijing Children′s Hospital-Rhabdomyosarcoma (BCH-RMS) regimen were analyzed. Survival data were analyzed by Kaplan-Meier survival analysis, and single factor analysis was performed by Log-Rank test. Results: The diagnostic age of 213 cases was 48.0 months (ranged 3.0-187.5 months), of which 136 cases (63.8%) were younger than 10 years old. The head and neck region was the most common primary site of tumor (30%, 64 cases), followed by the genitourinary tract (26.8%, 57 cases). Among pathological subtypes, embryonal RMS accounted for 71.4% (152 cases), while alveolar RMS and anaplastic RMS accounted for only 26.8% (57 cases) and 1.9% (4 cases), respectively. According to the Intergroup Rhabdomyosarcoma Study Group (IRS), IRS-Ⅲ and Ⅳ accounted for 85.0% (181 cases) of all RMS patients. In all patients, 9.4% (20 cases) patients were divided in to low-risk group, 52.1% (111 cases) patients in to intermediate -risk group, 25.8% (55 cases) patients in to high-risk group, and 12.7% (27 cases) patients in to the central nervous system invasion group, respectively. All patients with RMS received chemotherapy. The cycles of chemotherapy were 13.5 (ranged 5.0-18.0) for patients without event occurrence, while 14.2 (ranged 3.0-30.0) for patients with event occurrence. Among the 213 patients, 200 patients had surgical operation, of whom 103 patients underwent surgery before chemotherapy and 97 patients at the end of chemotherapy, 21 patients had secondary surgical resection. Radiotherapy was performed in 114 patients. The follow-up time was 23.0 months (ranged 0.5-151.0 months) . There were 98 patients with relapsed or progressed disease and 67 patients with death. The median time to progression was 10 months, of which 67 (68.4%) relapse occurred within 1 year and no recurrence occurred after follow-up for more than 5 years. The 3-year EFS and 5-year EFS were (52±4) % and (48±4) %, while the 3-year OS and 5-year OS were (65±4) % and (64±4) % by survival analysis. The 5-year OS of the low-risk, intermediate-risk, the high-risk were 100%, (74±5) %, (48±8) %, and the 2-year OS of the central nervous system invasion group was (36±11) % (χ²=33.52, P<0.01). The 5-year EFS of the low-risk, intermediate-risk, the high-risk were (93±6) %, (51±5) %, (36±7) % and the 2-year EFS of the central nervous system invasion group was (31±10) % (χ²=24.73, P<0.01) . Survival factor analysis suggested that the OS of children was correlated with age(χ²=4.16, P=0.038), tumor TNM stage (χ²=22.02, P=0.001), IRS group (χ²=4.49, P<0.01) and the risk group (χ²=33.52, P<0.01). Conclusions This study showed that the median age of newly diagnosed RMS patients was 4 years. The head and neck and the genitourinary tract were the most common primary origin of RMS. The OS was low in single-center RMS children. The median time to recurrence was 10 months, and recurrence was rare 3 years later.

Objective To compare the clinical features between cryptogenic stoke(CS)with and without right-to-left shunt(RLS)so as to determine whether shunt severity determined by control-enhanced transcranial Doppler(c-TCD)is correlated with the risk of paradoxical embolism(RoPE)score.Methods We made a retrospective analysis of clinical characteristics of 138 CS patients with and without RLS admitted to our department between January 2014 and November 2016.For patients documented by c-TCD,we evaluated whether there was a correlation between RLS severity and RoPE score. RLS was diagnosed by c-TCD and contrast-enhanced transthoracic echocardiography(c-TTE).We compared every modality for detecting RLS with and without Valsalva maneuver.For patients found with RLS in c-TCD and c-TTE,we judged whether there was an agreement in grading RLS between two modalities.Results For patients with CS,shunt severity by c-TCD was positively correlated with RoPE score(r= 0.26,P= 0.05).The clinical features were different between CS patients with RLS and without RLS.Compared with the positive results of c-TCD and c-TTE at rest,the positive rate was higher in Valsalva maneuver,respectively(P＜0.01).There was a moderate agreement between shunt grades identified by the two techniques(Kappa=0.428).Conclusion There is a positive correlation between RoPE score and RLS severity determined by c-TCD in CS patients.Valsalva maneuver can significantly increase the positive rate of RLS detected by c-TCD and c-TTE.

BACKGROUND: As a blood concentrate rich in growth factors and fibrin, platelet-rich fibrin (PRF) is able to significantly promote bone regeneration. PRF mixed with bone substitutes is commonly used to repair bone defects in oral maxillofacial region. But it remains controversial whether PRF as a sole material in sinus floor elevation can produce enough new bone tissues.OBJECTIVE: To evaluate the osteogenic potential of PRF as a sole grafting material in sinus floor elevation by means of an animal model.METHODS: Twelve healthy adult mongrel dogs aged 12-18 months were selected and randomized into three groups (groups A, B and C), with four dogs in each group. Upper first molars on both side of each dog were extracted 12 weeks prior to sinus floor elevation and simultaneous implants placement. Different materials were used to fill in the space between the sinus membrane and implant. Groups A, B and C were filled with PRF, autologus bone particles and autologus blood clot respectively. After 12 weeks, specimens were harvested to analyze the new bone formation by gross observation, X-ray examination and histological evaluation.RESULTS AND CONCLUSION: New bone formation was found to embrace all the implants close to the bony sinus floor, and the tips of all implants were free from bone coverage. The new bone height of groups A, B and C were (3.135±0.288),(3.218±0.345), and (1.898±0.157) mm, respectively. The new bone density of groups A, B and C were (65.06±5.88),(75.34±8.18), and (56.92±4.95) g/cm3, respectively. There were significant differences between the new bone height in groups A and C as well as in groups B and C (P < 0.05). Also, significant differences were found between the new bone density in groups A and B, B and C, A and C (P < 0.05). Within the confine of this experiment, it is feasible to use PRF as a sole grafting material in the sinus floor elevation to generate new bone, but the new bone volume is limited.

Objective To evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with gabapentin for treatment of recurrent pain after trigeminal radiofrequency thermocoagulation.Methods Forty patients of both sexes suffering from recurrent pain after trigeminal radiofrequency thermocoagulation,who refused surgical treatment,aged 45-80 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with visual analog scale score ≥4,with the course of recurrent pain 0.5-17.0 months,were randomized into 2 groups (n =20 each) using a random number table:gabapentin group (group A) and gabapentin plus rTMS group (group B).The patients were treated with 2 courses of rTMS in total (5 days for 1 course,1 time per day) and with the second course at a 2-day interval in group B.Effective analgesia and pain relief were recorded within 6 months after treatment,and the therapeutic efficacy was evaluated according to the modified Macnab criteria.The daily consumption of gabapentin and development of rTMS-and gabapentin-related adverse reactions were recorded.Results No rTMS-related adverse reactions were found in group B.Compared with group A,the rates of effective analgesia and pain relief were significantly increased,the therapeutic efficacy was enhanced,the daily consumption of gabapentin was decreased,and the incidence of gabapentin-related adverse reactions was decreased in group B (P＜0.05).Conclusion Combination of rTMS and gabapentin produces better efficacy than gabapentin alone when used to treat the recurrent pain after trigeminal radiofrequency thermocoagulation,and the safety is good.