OBJECTIVE: To observe the effect of electroacupuncture (EA) pretreatment of "biaoben acupoint combination" on cardiomyocyte mitochondrial fission in the rats with myocardial ischemia-reperfusion injury (MIRI) and explore its mechanism. METHODS: Fifty male SD rats were randomly divided into a sham-operation group, a model group, an EA pretreatment group, an EA pretreatment + Compound C group and an EA pretreatment+ML385 group, 10 rats in each group. In the EA pretreatment, the EA pretreatment + Compound C group and the EA pretreatment+ML385 group, EA was delivered at bilateral "Neiguan" (PC6), "Zusanli" (ST36) and "Guanyuan" (CV4) for 20 min, with continuous wave and 2 Hz of frequency, 1 mA of current, once daily for consecutive 7 days. On day 8, in the EA pretreatment + Compound C group and the EA pretreatment+ML385 group, 30 min before model preparation, the intraperitoneal injection with Compound C (0.3 mg/kg) and ML385 (30 mg/kg) was administered respectively. Except in the sham-operation group, the ligation of the left anterior descending coronary artery was performed to prepare MIRI rat model in the rest groups. In the sham-operation group, the thread was not ligated. After modeling, the content of reactive oxygen species (ROS) in the ischemic area was measured by flow cytometry, superoxide dismutase (SOD) was detected using xanthine oxidase method, and malondialdelyde (MDA) was detected using thiobarbituric acid (TBA) chromatometry. The morphology of myocardial tissue in the ischemic area was observed with HE staining, and the mitochondria ultrastructure of cardiomyocytes observed under transmission electron microscopy. Using immunofluorescence analysis, the positive expression of mitochondrial fission factor (MFF), mitochondrial fission 1 protein antibody (Fis1) and dynamin-related protein 1 (Drp1) was detected; and with immunohistochemical method used, the protein expression of adenosine monophosphate-activated protein kinase (AMPK), nuclear factor E2-associated factor2 (Nrf2) and Drp1 in the ischemic area was detected. RESULTS: Compared with the sham-operation group, the content of ROS and MDA in the myocardial tissue of the ischemic area, and the positive expression of MFF, Fis1 and Drp1 increased in the model group (P<0.01); the content of SOD and the protein expression of AMRK and Nrf2 decreased (P<0.01), and the protein expression of Drp1 elevated (P<0.01). Compared with the model group, the content of ROS and MDA in the myocardial tissue of the ischemic area, and the positive expression of MFF, Fis1 and Drp1 were dropped in the EA pretreatment group (P<0.01); the content of SOD and the protein expression of AMRK and Nrf2 rose (P<0.01), and the protein expression of Drp1 declined (P<0.01); and in the EA pretreatment+Compound C group and the EA pretreatment+ML385 group, the positive expression of MFF, Fis1 and Drp1, and the protein expression of Drp1 were all reduced (P<0.01). When compared with the EA pretreatment + Compound C group and the EA pretreatment+ML385 group, the content of ROS and MDA in the myocardial tissue of the ischemic area, and the positive expression of MFF, Fis1 and Drp1 were dropped in the EA pretreatment group (P<0.01); the content of SOD and the protein expression of AMRK and Nrf2 rose (P<0.01, P<0.05), and the protein expression of Drp1 decreased (P<0.05). In comparison with the model group, the EA pretreatment+Compound C group and the EA pretreatment+ML385 group, the cardiac muscle fiber rupture, cell swelling and mitochondrial disorders were obviously alleviated in the EA pretreatment group. The morphological changes were similar among the model group, the EA pretreatment+Compound C group and the EA pretreatment+ML385 group. CONCLUSION Electroacupuncture pretreatment of "biaoben acupoint combination" attenuates myocardial injury in MIRI rats, probably through promoting the phosphorylation of AMPK and Nrf2, inhibiting the excessive mitochondrial fission induced by Drp1, and reducing mitochondrial dysfunction caused by mitochondrial fragmentation and vacuolation.
Animals ; Electroacupuncture ; Male ; Rats, Sprague-Dawley ; Myocardial Reperfusion Injury/physiopathology* ; Myocytes, Cardiac/cytology* ; Rats ; Acupuncture Points ; Mitochondrial Dynamics ; Humans ; Reactive Oxygen Species/metabolism* ; NF-E2-Related Factor 2/genetics* ; Superoxide Dismutase/metabolism*

Objective To analyze the clinical distribution,drug resistance characteristics,molecular prevalence,and impact of immunocompromised status on the infection rate of carbapenem-resistant Enterobacteriaceae(CRE)isolated from pediatric respiratory tract samples(sputum,bronchoalveolar lavage fluid).Methods A retrospective analysis was conducted on clinical data of hospitalized children from 2019 to 2023.A total of 1 235 non-repetitive strains of Enterobacteriaceae bacteria were obtained from pediactric respiratory tract samples.Drug susceptibility testing,multilocus sequencing typing(MLST),and resistance-related gene sequencing were performed on 100 isolated CRE strains,to study the clinical distribution,drug resistance characteristics,and molecular prevalence of CRE,and to further analyze the impact of immunocompromised status on the respiratory CRE infection rate in children.Results From 2019 to 2023,the detection rate of CRE in 1 235 strains of Enterobacteriaceae bacteria was 8.10%(100/1 235).Among them,51.0%(51/100)of CRE were isolated from the intensive care unit(ICU),of which 33.0%(33/100)were isolated from the Surgical ICU,18.0%(18/100)of CRE was isolated from the Medical ICU;32.0%(32/100)of CRE were isolated from Department of Neonatology,with the majority(74.0%)isolated from infants under 6 months of age.Of all pediatric patients,85.0%recovered and were discharged after treatment.Immunocompromised status was identified as an independent risk factor for CRE infection.Among 100 strains of CRE,Carbapenem-resistant Klebsiella pneumoniae(CRKP)was the most commonly detected strain,accounting for 88.0%(88/100),followed by Escherichia coli at 6.0%(6/100)and Enterobacter cloacae at 4.0%(4/100).CRE strains were highly resistant to carbapenems and cephalosporins,with prevalent resistance to amikacin,ciprofloxacin,and levofloxacin.However,their resistance rates were relatively low to tigecycline,colistin,minocycline,ceftazidime/avibactam,meropenem/vaborbactam,and imipenem/relebactam.The screening results of carbapenem resistance genes showed that blaKPC-2 was the most prevalent gene(74.0%),followed by blaNDM-1(14.0%)and blaNDM-5(11.0%).Molecular typing showed that ST11 type CRE was the dominant type,comprising 72.0%(72/100)and was the primary epidemic clone.Conclusions CRKP is the most prevalent CRE strain isolated from pediatric respiratory tract samples,primarily identified in the ICU,Department of Neonatology,and among infants under 6 months of age.Immunocompromised status is an independent risk factor for respiratory CRE infection in children.CRE generally has high resistance to antibacterial drugs,with blaKPC-2 being the dominant resistance genotype,and ST11 as the predominant multilocus sequence type.Clinical management should account for these characteristics to implement timely interventions and rational therapeutic strategies.

Objective To investigate the antimicrobial resistance patterns of carbapenem-resistant Klebsiella pneumoniae(CRKP)strains isolated from children for better prevention,treatment,and control of CRKP infections in children.Methods A total of 182 clinical CRKP strains were collected between January 2018 and December 2020 in Hebei Children's Hospital.All CRKP strains were identified by matrix-assisted laser desorption ionization-time of flight(MALDI-TOF)mass spectrometry.The common carbapenemase genes(blaKPC,blaNDM,blaIMP,blaVIM,blaOXA-48)of CRKP isolates were studied by PCR.Multilocus sequence typing(MLST)was performed for homology analysis.Results The 182 children infected with CRKP were mainly infants(＞28 days to＜1 years),accounting for 49.45％(90/182),followed by newborns(≤28 days),accounting for 36.26％(66/182).The main source of the 182 CRKP isolates was sputum(50.55％,92/182),blood(15.93％,29/182),and urine(13.19％,24/182).The strains were mainly isolated from patients in neonatology(30.22％,55/182),general surgery(21.43％,39/182),cardiac surgery(13.19％,24/182),and intensive care unit(11.54％,21/182).Antimicrobial susceptibility testing showed that all of the 182 CRKP strains were resistant to cefepime,ceftazidime,piperacillin-tazobactam,and cefoperazone-sulbactam(100％).Overall,97.8％,71.4％,81.9％,75.8％,69.2％,and 2.7％of the strains were resistant to aztreonam,amikacin,ciprofloxacin,levofloxacin,doxycycline,and tigecycline,respectively.The prevalence of carbapenemase gene blaKPC-2 was the highest(73.63％,134/182),followed by blaNDM-5(15.38％,28/182),and blaNDM-1(11.54％,21/182).A total of 15 different sequence types(ST)were identified by MLST,of which ST11 was the most common type(72.53％,132/182),followed by ST17(11.54％,21/182).Conclusions CRKP isolates in Hebei Children's Hospital showed high level resistance to antimicrobial agents.Antimicrobial therapy should be prescribed cautiously according to the results of antimicrobial susceptibility testing to avoid the emergence of resistant strains.KPC-2-producing ST1 1 type CRKP strains may be prevalent in this hospital.Effective control measures should be taken to avoid further spread of such CRKP strains.

Objective To investigate the antimicrobial resistance patterns of carbapenem-resistant Klebsiella pneumoniae(CRKP)strains isolated from children for better prevention,treatment,and control of CRKP infections in children.Methods A total of 182 clinical CRKP strains were collected between January 2018 and December 2020 in Hebei Children's Hospital.All CRKP strains were identified by matrix-assisted laser desorption ionization-time of flight(MALDI-TOF)mass spectrometry.The common carbapenemase genes(blaKPC,blaNDM,blaIMP,blaVIM,blaOXA-48)of CRKP isolates were studied by PCR.Multilocus sequence typing(MLST)was performed for homology analysis.Results The 182 children infected with CRKP were mainly infants(＞28 days to＜1 years),accounting for 49.45％(90/182),followed by newborns(≤28 days),accounting for 36.26％(66/182).The main source of the 182 CRKP isolates was sputum(50.55％,92/182),blood(15.93％,29/182),and urine(13.19％,24/182).The strains were mainly isolated from patients in neonatology(30.22％,55/182),general surgery(21.43％,39/182),cardiac surgery(13.19％,24/182),and intensive care unit(11.54％,21/182).Antimicrobial susceptibility testing showed that all of the 182 CRKP strains were resistant to cefepime,ceftazidime,piperacillin-tazobactam,and cefoperazone-sulbactam(100％).Overall,97.8％,71.4％,81.9％,75.8％,69.2％,and 2.7％of the strains were resistant to aztreonam,amikacin,ciprofloxacin,levofloxacin,doxycycline,and tigecycline,respectively.The prevalence of carbapenemase gene blaKPC-2 was the highest(73.63％,134/182),followed by blaNDM-5(15.38％,28/182),and blaNDM-1(11.54％,21/182).A total of 15 different sequence types(ST)were identified by MLST,of which ST11 was the most common type(72.53％,132/182),followed by ST17(11.54％,21/182).Conclusions CRKP isolates in Hebei Children's Hospital showed high level resistance to antimicrobial agents.Antimicrobial therapy should be prescribed cautiously according to the results of antimicrobial susceptibility testing to avoid the emergence of resistant strains.KPC-2-producing ST1 1 type CRKP strains may be prevalent in this hospital.Effective control measures should be taken to avoid further spread of such CRKP strains.

Objective To analyze the clinical distribution,drug resistance characteristics,molecular prevalence,and impact of immunocompromised status on the infection rate of carbapenem-resistant Enterobacteriaceae(CRE)isolated from pediatric respiratory tract samples(sputum,bronchoalveolar lavage fluid).Methods A retrospective analysis was conducted on clinical data of hospitalized children from 2019 to 2023.A total of 1 235 non-repetitive strains of Enterobacteriaceae bacteria were obtained from pediactric respiratory tract samples.Drug susceptibility testing,multilocus sequencing typing(MLST),and resistance-related gene sequencing were performed on 100 isolated CRE strains,to study the clinical distribution,drug resistance characteristics,and molecular prevalence of CRE,and to further analyze the impact of immunocompromised status on the respiratory CRE infection rate in children.Results From 2019 to 2023,the detection rate of CRE in 1 235 strains of Enterobacteriaceae bacteria was 8.10%(100/1 235).Among them,51.0%(51/100)of CRE were isolated from the intensive care unit(ICU),of which 33.0%(33/100)were isolated from the Surgical ICU,18.0%(18/100)of CRE was isolated from the Medical ICU;32.0%(32/100)of CRE were isolated from Department of Neonatology,with the majority(74.0%)isolated from infants under 6 months of age.Of all pediatric patients,85.0%recovered and were discharged after treatment.Immunocompromised status was identified as an independent risk factor for CRE infection.Among 100 strains of CRE,Carbapenem-resistant Klebsiella pneumoniae(CRKP)was the most commonly detected strain,accounting for 88.0%(88/100),followed by Escherichia coli at 6.0%(6/100)and Enterobacter cloacae at 4.0%(4/100).CRE strains were highly resistant to carbapenems and cephalosporins,with prevalent resistance to amikacin,ciprofloxacin,and levofloxacin.However,their resistance rates were relatively low to tigecycline,colistin,minocycline,ceftazidime/avibactam,meropenem/vaborbactam,and imipenem/relebactam.The screening results of carbapenem resistance genes showed that blaKPC-2 was the most prevalent gene(74.0%),followed by blaNDM-1(14.0%)and blaNDM-5(11.0%).Molecular typing showed that ST11 type CRE was the dominant type,comprising 72.0%(72/100)and was the primary epidemic clone.Conclusions CRKP is the most prevalent CRE strain isolated from pediatric respiratory tract samples,primarily identified in the ICU,Department of Neonatology,and among infants under 6 months of age.Immunocompromised status is an independent risk factor for respiratory CRE infection in children.CRE generally has high resistance to antibacterial drugs,with blaKPC-2 being the dominant resistance genotype,and ST11 as the predominant multilocus sequence type.Clinical management should account for these characteristics to implement timely interventions and rational therapeutic strategies.

Objective To analyze the characteristics and distribution of TCM syndromes of advanced gastric cancer;To provide reference for the standardization and clinical research of TCM syndromes of advanced gastric cancer.Methods The four diagnosis information with advanced gastric cancer was retrospectively collected at Dongzhimen Hospital of Beijing University of Chinese Medicine from January 2010 to December 2020.And the investigation results were analyzed by combining principal component analysis and clustering analysis,so as to explore the distribution pattern of TCM syndromes of advanced gastric cancer.Results Totally 164 patients were included,involving 601 case-times.10 principal components were obtained through principal component analysis on 29 items of four diagnosis information.The four diagnosis information with factor coefficient>0.4 were selected and allocated to the 10 principal components.Then,based on the results of principal component analysis,clustering analysis was conducted to obtain the distribution proportion of the three types of TCM syndromes.According to the syndrome differentiation by professional clinicians,the results were followed by the frequency distribution as cold coagulation and blood stasis(356,59.28%),stomach yin deficiency(145,24.17%)and phlegm-heat accumulation(100,16.55%).Conclusion There are three basic TCM syndromes of advanced gastric cancer,which are cold coagulation and blood stasis,stomach yin deficiency and phlegm-heat accumulation.Cold coagulation and blood stasis occupies the largest proportion,and the treatment should be based on warming the middle to dissipate cold and promoting blood circulation to remove blood stasis.

Objective:To explore the effect of nursing intervention based on the health action process approach (HAPA) theory on follow-up compliance and blood glucose management of patients with diabetes retinopathy (DR) .Methods:From October 2022 to May 2023, 102 DR patients who visited the Diabetes Fundus Clinic of Shanxi Eye Hospital were selected by convenience sampling as participants. A total of 51 patients who visited from October 2022 to January 2023 were selected as control group, and 51 patients who visited from February to May 2023 were selected as observation group. Control group received routine nursing, while observation group received nursing intervention based on HAPA theory on this basis. The follow-up compliance, Chinese version of the Compliance with Annual Diabetic Eye Exams Survey (CADEES-C) score, fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG) and glycosylated hemoglobin (HbA1c) were compared between the two groups.Results:The compliance of DR patients in observation group after six months of follow-up was higher than that in control group, and the difference was statistically significant ( P<0.05). After six months, the CADEES-C dimension scores and total score of DR patients in observation group were higher than those in control group, and the differences were statistically significant ( P<0.05). FBG and 2hPG of DR patients in observation group were lower than those in control group after three and six months, and the differences were statistically significant ( P<0.05). After six months of intervention, there was no statistically significant difference in HbA1c between observation group and control group ( P>0.05) . Conclusions:Nursing interventions based on HAPA theory can effectively improve the follow-up compliance of DR patients, enhance their health beliefs during follow-up, and improve their blood glucose.

Objective To investigate the distribution and antimicrobial resistance profiles of pathogenic bacteria in Children's Hospital of Hebei Province to inform reasonable use of antibiotics.Methods Antimicrobial susceptibility of the bacterial isolates was tested using Kirby-Bauer method,VITEK-2 Compact,BD Phoenix 100 automated systems,and E-test method.The results were interpreted according to the breakpoints recommended by the Clinical and Laboratory Standards Institute (CLSI) in 2022.Results were analyzed by WHONET 5.6 software.Results A total of 11909 isolates were collected from 2020 to 2022,of which 45.1％ were Gram positive organisms and 54.9％ were Gram negative organisms.The prevalence of MRSA and in S.aureus and MRCNS in coagulase-negative Staphylococcus was 36.8％ and 73.8％,respectively.The resistance rate of Enterococcus faecalis and Enterococcus faecium to ampicillin was 2.6％ and 93.5％,respectively,while the resistance rates of E.faecalis and E.faecium to high concentration gentamicin was 42.2％ and 66.2％,respectively.E.faecium showed significantly higher resistance rates to the antibiotics tested than E.faecalis.The prevalence of PRSP and PSSP was 1.7％ and 95.7％ respectively in the non-meningitis S.pneumoniae isolates.No vancomycin-or linezolid-resistant strains were found in Staphylococcus,Enterococcus,or Streptococcus.The prevalence of ESBLs-producing E.coli and K.pneumoniae was 47.4％ and 32.3％,respectively.The prevalence of carbapenem-resistant E.coli and K.pneumoniae was 2.0％ and 22.4％,respectively.The prevalence of carbapenem-resistant P.aeruginosa (CRPA) and carbapenem-resistant A.baumannii (CRAB) was 9.5％ and 22.1％,respectively.The resistance rate of Haemophilus influenzae to ampicillin was 83.8％.The prevalence of β-lactamase-producing H.influenzae and β-lactamase-non-producing ampicillin-resistant (BLNAR) H.influenzae was 76.1％ and 7.7％,respectively.No meropenem-resistant strains were found in H.influenzae.Majority (98.0％) of Moraxella catarrhalis strains produced β-lactamase.Conclusions Multi-drug resistant bacterial pathogens are still serious in pediatric inpatients.The common clinical isolates showed various levels of resistance to different antimicrobial agents.It is important to continue the surveillance of bacterial resistance in children,take proactive measures to curb the spread of drug-resistant bacteria,and use antibiotics rationally.

Objective To investigate the distribution and antimicrobial resistance profiles of pathogenic bacteria in Children's Hospital of Hebei Province to inform reasonable use of antibiotics.Methods Antimicrobial susceptibility of the bacterial isolates was tested using Kirby-Bauer method,VITEK-2 Compact,BD Phoenix 100 automated systems,and E-test method.The results were interpreted according to the breakpoints recommended by the Clinical and Laboratory Standards Institute (CLSI) in 2022.Results were analyzed by WHONET 5.6 software.Results A total of 11909 isolates were collected from 2020 to 2022,of which 45.1％ were Gram positive organisms and 54.9％ were Gram negative organisms.The prevalence of MRSA and in S.aureus and MRCNS in coagulase-negative Staphylococcus was 36.8％ and 73.8％,respectively.The resistance rate of Enterococcus faecalis and Enterococcus faecium to ampicillin was 2.6％ and 93.5％,respectively,while the resistance rates of E.faecalis and E.faecium to high concentration gentamicin was 42.2％ and 66.2％,respectively.E.faecium showed significantly higher resistance rates to the antibiotics tested than E.faecalis.The prevalence of PRSP and PSSP was 1.7％ and 95.7％ respectively in the non-meningitis S.pneumoniae isolates.No vancomycin-or linezolid-resistant strains were found in Staphylococcus,Enterococcus,or Streptococcus.The prevalence of ESBLs-producing E.coli and K.pneumoniae was 47.4％ and 32.3％,respectively.The prevalence of carbapenem-resistant E.coli and K.pneumoniae was 2.0％ and 22.4％,respectively.The prevalence of carbapenem-resistant P.aeruginosa (CRPA) and carbapenem-resistant A.baumannii (CRAB) was 9.5％ and 22.1％,respectively.The resistance rate of Haemophilus influenzae to ampicillin was 83.8％.The prevalence of β-lactamase-producing H.influenzae and β-lactamase-non-producing ampicillin-resistant (BLNAR) H.influenzae was 76.1％ and 7.7％,respectively.No meropenem-resistant strains were found in H.influenzae.Majority (98.0％) of Moraxella catarrhalis strains produced β-lactamase.Conclusions Multi-drug resistant bacterial pathogens are still serious in pediatric inpatients.The common clinical isolates showed various levels of resistance to different antimicrobial agents.It is important to continue the surveillance of bacterial resistance in children,take proactive measures to curb the spread of drug-resistant bacteria,and use antibiotics rationally.

Although the development of COVID-19 vaccines has been a remarkable success, the heterogeneous individual antibody generation and decline over time are unknown and still hard to predict. In this study, blood samples were collected from 163 participants who next received two doses of an inactivated COVID-19 vaccine (CoronaVac®) at a 28-day interval. Using TMT-based proteomics, we identified 1,715 serum and 7,342 peripheral blood mononuclear cells (PBMCs) proteins. We proposed two sets of potential biomarkers (seven from serum, five from PBMCs) at baseline using machine learning, and predicted the individual seropositivity 57 days after vaccination (AUC = 0.87). Based on the four PBMC's potential biomarkers, we predicted the antibody persistence until 180 days after vaccination (AUC = 0.79). Our data highlighted characteristic hematological host responses, including altered lymphocyte migration regulation, neutrophil degranulation, and humoral immune response. This study proposed potential blood-derived protein biomarkers before vaccination for predicting heterogeneous antibody generation and decline after COVID-19 vaccination, shedding light on immunization mechanisms and individual booster shot planning.
Humans ; COVID-19 Vaccines ; Leukocytes, Mononuclear ; Proteomics ; COVID-19/prevention & control* ; Vaccination ; Antibodies ; Antibodies, Viral ; Antibodies, Neutralizing