Objective To compare the peripheral nerve conduction function among elderly individuals with late life depression(LLD),those with Alzheimer disease(AD),and with normal cognition(NC).Methods 29 LLD patients and 30 AD patients hospitalized in the Geriatrics Department,as well as 52 matched NC elderly(60 years old and over)were selected.Test and compare the sensory nerve conduction of the median nerve and the sural nerve,as well as the motor nerve conduction of the median nerve and the common peroneal nerve.The nerve conduction indicators were latency,amplitude,and conduction velocity.Results After controlling for gender,age,height,educational level,and somatic diseases with inter-group differences,the proximal latency[3.13(2.82,3.48)ms vs.3.62(3.10,4.42)ms,P=0.023],amplitude[proximal,(7.20±2.43)mV vs.(4.01±2.99)mV,P<0.001;distal,(6.16±2.25)mV vs.(4.03±3.19)mV,P<0.001],and velocity[(56.23±5.29)m/s vs.(49.44±5.87)m/s,P=0.002]of the median motor nerve conduction in AD group were worse than those in NC group.The latency[proximal,3.13(2.82,3.48)ms vs.4.17(3.36,4.85)ms,P<0.001;distal,7.24(6.82,7.84)ms vs.8.02(7.37,8.83)ms,P<0.001],and amplitude[proximal,(7.20±2.43)mV vs.(3.27±2.80)mV,P<0.001;distal,(6.16±2.25)mV vs.(3.05±2.85)mV,P<0.001]of the median motor nerve conduction in LLD group were worse than those in NC group as well.In terms of the common peroneal motor nerve conduction function,compared to NC group,AD group had slower velocity[(48.77±5.71)m/s vs.(41.86±5.02)m/s,P=0.033],and LLD group had longer proximal latency[4.14(3.38,5.48)ms vs.5.68(5.16,7.55)ms,P<0.001].Conclusion Both AD and LLD showed peripheral motor nerve conduction impairment,but with different patterns of dysfunction.These findings provided new directions for research into the mechanisms of the disease.

Objective:To report the nationwide surveillance results of pathogenic profiles and antimicrobial resistance patterns of Gram-positive bloodstream infections in China in 2023.Methods:The clinical isolates of Gram-posttive bacteria from blood cultures were collected in member hospitals of National Bloodstream Infection Bacterial Resistant Investigation Collaborative System（BRICS）during January to December 2023. Antimicrobial susceptibility testing was performed using the dilution method recommended by the Clinical and Laboratory Standards Institute（CLSI）. Statistical analyses were conducted using WHONET 5.6 and SPSS 25.0 software.Results:A total of 4 385 Gram-positive bacterial isolates were obtained from 60 participating center. The top five pathogens were Staphylococcus aureus（ n=1 544，35.2%），coagulase-negative Staphylococci（ n=1 441，32.9%）， Enterococcus faecium（ n=574，13.1%）， Enterococcus faecalis（ n=385，8.8%），and α-hemolytic Streptococci（ n=187，4.3%）. The prevalence of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococci（MRCNS）was 26.2%（405/1 544）and 69.8%（1 006/1 441），respectively. Notably，all Staphylococci remained susceptible to glycopeptide or daptomycin. Staphylococcus aureus demonstrated excellent susceptibility（>97.0%）to cephalobiol，rifampicin，trimethoprim-sulfamethoxazole，linezolid，minocycline，tigecycline，and eravacycline. No Enterococcus exhibiting resistance to linezolid were detected. Glycopeptide resistance was uncommon but more frequent in Enterococcus faecium（resistance to vancomycin and teicoplanin：both 1.7%）compared to Enterococcus faecalis（both 0.3%）. The detection rates of MRSA and MRCNS exhibited significant regional variations across the country（ χ2=17.674 and 148.650，respectively，both P<0.001）. No vancomycin-resistant Enterococci were detected in central China. Institutional comparison demonstrated higher prevalence of MRSA（ χ2=14.111， P<0.001）and MRCNS（ χ2=4.828， P=0.028）in provincial hospitals than that in municipal hospitals. Socioeconomic analysis identified elevated detection rates of both MRSA（ χ2=18.986， P<0.001）and MRCNS（ χ2=4.477， P=0.034）in less developed regions（per capita GDP

Objective:To report the results of bacterial resistant investigation collaborative system（BRICS）on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2023，and provide reference for clinical tretment of bloodstream infections and prevention and control of bacterial resistance.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of BRICS were collected during January 2023 to December 2023. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 were used to analyze the data.Results:During the study period，11 492 strains of Gram-negative bacteria were collected from 60 hospitals，of which 10 098（87.9%）were Enterobacterales and 1 394（12.1%）were non-fermentative bacteria. The top 5 bacterial species were Escherichia coli（50.0%）， Klebsiella pneumoniae（26.1%）， Pseudomonas aeruginosa（5.1%）， Acinetobacter baumannii complex（5.0%）and Enterobacter cloacae complex（4.1%）. The ESBL-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus mirablilis were 46.8%（2 685/5 741），18.3%（549/2 999）and 44.0%（77/175），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（76/5 741）and 15.0%（450/2 999）；32.9%（25/76）and 78.0%（351/450）of CREC and CRKP were sensitive to ceftazidime/avibactam combination，respectively. 94.7%（72/76）and 90.2%（406/450）of CREC and CRKP were sensitive to aztreonam/avibactam combination. Furthermore，57.9%（44/76）and 79.1%（356/450）were sensitive to imipenem/relebactam combination. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 64.6%（370/573），while more than 80.0% of CRAB complex was sensitive to tigecycline，eravacycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 17.0%（99/581）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of important Gram-negative bacteria resistance among different regions in China，with statistically significant differences in the prevalence of CREC，CRKP，CRPA and CRAB complex（ χ2=10.6，28.6，10.8 and 19.3， P<0.05）. The prevalence of ESBL-producing Escherichia coli， CREC，CRAB complex and CRKP were higher in provincial hospitals than those in municipal hospitals（ χ2=12.5，9.8，12.7 and 57.8，all P<0.01）. Conclusions:Gram-negative bacteria are the main pathogens causing bloodstream infections in China，and Escherichia coli is ranked in the top，while the trend of Klebsiella pneumoniae increases continuously with time. CRKP infection shows a slow upward trend，CREC infecton maintains a low prevalence level，and CRAB complex infection continues to exhibit a high prevalence rate. The composition and resistance patterns of pathogens causing bloodstream infections vary to some extent across different regions and levels of hospitals in China.

Objective:To report the nationwide surveillance results of pathogenic profiles and antimicrobial resistance patterns of Gram-positive bloodstream infections in China in 2023.Methods:The clinical isolates of Gram-posttive bacteria from blood cultures were collected in member hospitals of National Bloodstream Infection Bacterial Resistant Investigation Collaborative System（BRICS）during January to December 2023. Antimicrobial susceptibility testing was performed using the dilution method recommended by the Clinical and Laboratory Standards Institute（CLSI）. Statistical analyses were conducted using WHONET 5.6 and SPSS 25.0 software.Results:A total of 4 385 Gram-positive bacterial isolates were obtained from 60 participating center. The top five pathogens were Staphylococcus aureus（ n=1 544，35.2%），coagulase-negative Staphylococci（ n=1 441，32.9%）， Enterococcus faecium（ n=574，13.1%）， Enterococcus faecalis（ n=385，8.8%），and α-hemolytic Streptococci（ n=187，4.3%）. The prevalence of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococci（MRCNS）was 26.2%（405/1 544）and 69.8%（1 006/1 441），respectively. Notably，all Staphylococci remained susceptible to glycopeptide or daptomycin. Staphylococcus aureus demonstrated excellent susceptibility（>97.0%）to cephalobiol，rifampicin，trimethoprim-sulfamethoxazole，linezolid，minocycline，tigecycline，and eravacycline. No Enterococcus exhibiting resistance to linezolid were detected. Glycopeptide resistance was uncommon but more frequent in Enterococcus faecium（resistance to vancomycin and teicoplanin：both 1.7%）compared to Enterococcus faecalis（both 0.3%）. The detection rates of MRSA and MRCNS exhibited significant regional variations across the country（ χ2=17.674 and 148.650，respectively，both P<0.001）. No vancomycin-resistant Enterococci were detected in central China. Institutional comparison demonstrated higher prevalence of MRSA（ χ2=14.111， P<0.001）and MRCNS（ χ2=4.828， P=0.028）in provincial hospitals than that in municipal hospitals. Socioeconomic analysis identified elevated detection rates of both MRSA（ χ2=18.986， P<0.001）and MRCNS（ χ2=4.477， P=0.034）in less developed regions（per capita GDP

Objective:To report the results of bacterial resistant investigation collaborative system（BRICS）on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2023，and provide reference for clinical tretment of bloodstream infections and prevention and control of bacterial resistance.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of BRICS were collected during January 2023 to December 2023. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 were used to analyze the data.Results:During the study period，11 492 strains of Gram-negative bacteria were collected from 60 hospitals，of which 10 098（87.9%）were Enterobacterales and 1 394（12.1%）were non-fermentative bacteria. The top 5 bacterial species were Escherichia coli（50.0%）， Klebsiella pneumoniae（26.1%）， Pseudomonas aeruginosa（5.1%）， Acinetobacter baumannii complex（5.0%）and Enterobacter cloacae complex（4.1%）. The ESBL-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus mirablilis were 46.8%（2 685/5 741），18.3%（549/2 999）and 44.0%（77/175），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（76/5 741）and 15.0%（450/2 999）；32.9%（25/76）and 78.0%（351/450）of CREC and CRKP were sensitive to ceftazidime/avibactam combination，respectively. 94.7%（72/76）and 90.2%（406/450）of CREC and CRKP were sensitive to aztreonam/avibactam combination. Furthermore，57.9%（44/76）and 79.1%（356/450）were sensitive to imipenem/relebactam combination. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 64.6%（370/573），while more than 80.0% of CRAB complex was sensitive to tigecycline，eravacycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 17.0%（99/581）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of important Gram-negative bacteria resistance among different regions in China，with statistically significant differences in the prevalence of CREC，CRKP，CRPA and CRAB complex（ χ2=10.6，28.6，10.8 and 19.3， P<0.05）. The prevalence of ESBL-producing Escherichia coli， CREC，CRAB complex and CRKP were higher in provincial hospitals than those in municipal hospitals（ χ2=12.5，9.8，12.7 and 57.8，all P<0.01）. Conclusions:Gram-negative bacteria are the main pathogens causing bloodstream infections in China，and Escherichia coli is ranked in the top，while the trend of Klebsiella pneumoniae increases continuously with time. CRKP infection shows a slow upward trend，CREC infecton maintains a low prevalence level，and CRAB complex infection continues to exhibit a high prevalence rate. The composition and resistance patterns of pathogens causing bloodstream infections vary to some extent across different regions and levels of hospitals in China.

Objective To compare the peripheral nerve conduction function among elderly individuals with late life depression(LLD),those with Alzheimer disease(AD),and with normal cognition(NC).Methods 29 LLD patients and 30 AD patients hospitalized in the Geriatrics Department,as well as 52 matched NC elderly(60 years old and over)were selected.Test and compare the sensory nerve conduction of the median nerve and the sural nerve,as well as the motor nerve conduction of the median nerve and the common peroneal nerve.The nerve conduction indicators were latency,amplitude,and conduction velocity.Results After controlling for gender,age,height,educational level,and somatic diseases with inter-group differences,the proximal latency[3.13(2.82,3.48)ms vs.3.62(3.10,4.42)ms,P=0.023],amplitude[proximal,(7.20±2.43)mV vs.(4.01±2.99)mV,P<0.001;distal,(6.16±2.25)mV vs.(4.03±3.19)mV,P<0.001],and velocity[(56.23±5.29)m/s vs.(49.44±5.87)m/s,P=0.002]of the median motor nerve conduction in AD group were worse than those in NC group.The latency[proximal,3.13(2.82,3.48)ms vs.4.17(3.36,4.85)ms,P<0.001;distal,7.24(6.82,7.84)ms vs.8.02(7.37,8.83)ms,P<0.001],and amplitude[proximal,(7.20±2.43)mV vs.(3.27±2.80)mV,P<0.001;distal,(6.16±2.25)mV vs.(3.05±2.85)mV,P<0.001]of the median motor nerve conduction in LLD group were worse than those in NC group as well.In terms of the common peroneal motor nerve conduction function,compared to NC group,AD group had slower velocity[(48.77±5.71)m/s vs.(41.86±5.02)m/s,P=0.033],and LLD group had longer proximal latency[4.14(3.38,5.48)ms vs.5.68(5.16,7.55)ms,P<0.001].Conclusion Both AD and LLD showed peripheral motor nerve conduction impairment,but with different patterns of dysfunction.These findings provided new directions for research into the mechanisms of the disease.

BACKGROUND:Rapid developments in the field of bioinformatics have provided new methods for the diagnosis of osteoarthritis.Artificial neural networks have powerful data computing and classification capabilities,which have shown better performance in disease diagnosis. OBJECTIVE:To establish a new diagnostic predictive model of osteoarthritis based on artificial neural network and to verify the diagnostic value of the model in osteoarthritis with an external dataset. METHODS:The eligible osteoarthritis-related data sets were downloaded through GEO database search and divided into Train group and Test group.The gene expression matrix of the Train group was analyzed to screen the differentially expressed genes.GO and KEGG enrichment analyses were performed on the differentially expressed genes.Through Lasso regression model,support vector machine model and random forest tree model,the key genes of osteoarthritis were further identified from the differentially expressed genes.The R software"Neuralnet"package was then used to construct the osteoarthritis diagnosis model based on artificial neural network,and the model performance was evaluated by the five-fold cross-validation.Two independent data sets in the Test group were used to verify their diagnostic results. RESULTS AND CONCLUSION:A total of 90 differentially expressed genes related to osteoarthritis were obtained by differential analysis,of which 33 were down-regulated and 57 were up-regulated.GO enrichment analysis showed that the differentially expressed genes were mainly involved in the following biological processes,including leukocyte-mediated immunity,leukocyte migration in bone marrow and chemokine production.KEGG enrichment analysis showed that these genes were mainly enriched in rheumatoid arthritis,interleukin-17 signaling pathway and osteoclast differentiation pathway.Five key genes for the diagnosis of osteoarthritis,HMGB2,GADD45A,SLC19A2,TPPP3 and FOLR2,were identified by three machine learning methods.The artificial neural network model of five key genes in the Train group showed that the accuracy was 96.36%and the area under the curve was 0.997.The five-fold cross validation of the neural network model showed that the average area under the curve was greater than 0.9 and the model was of robustness.Two independent data sets in the Test group showed its area under the curve was 0.814 and 0.788 respectively.Therefore,the establishment of an artificial neural network model for the diagnosis of osteoarthritis has a certain diagnostic value.

Objective To explore the correlation between smoking,light to moderate alcohol consumption and cognitive function in elderly men in the community.Methods One thousand two hundred one elderly men(excluding heavy drinkers)from the Chinese longitudinal aging cohort database were selected and divided into smoking and drinking group(n=332),non-smoking but drinking group(n=126),smoking but non-drinking group(n=308),and non-smoking and non-drinking group(n=435)based on self-provided smoking and drinking information.Cognitive function was evaluated using the Beijing version of the Montreal cognitive assessment(MoCA).A two factor ANOVA and a multiple factor linear regression model were used to analyze differences in cognitive function,and risk factors for cognitive decline,respectively.Results The main effect analysis indicated that light to moderate alcohol consumption had a statistically significant impact on MoCA total score(F=6.076,P=0.014),MoCA naming(F=1.179,P=0.001),and MoCA abstraction(F=7.718,P=0.006).Light to moderate drinkers had lower MoCA total score(22.50±5.27 vs.23.30±5.28),MoCA naming(2.41±0.85 vs.2.58±0.76),and MoCA abstraction(0.93±0.84 vs.1.10±0.82)compared to non-drinkers.The main effects of smoking on MoCA total score(F=0.234,P=0.628),MoCA naming(F=0.110,P=0.741),and MoCA abstraction(F=1.335,P=0.248)were not significant.There was no interaction between smoking and light to moderate alcohol consumption on MoCA score(P>0.05).The results of multiple factor linear regression analysis showed a positive correlation(B=0.125,P=0.008)between no history of light to moderate alcohol consumption and MoCA naming.A stratified analysis of non-dementia individuals showed a positive correlation between a history of light to moderate alcohol consumption and MoCA total score(B=0.550,P=0.011)and MoCA naming(B=0.134,P=0.002).Conclusion Smoking and light to moderate alcohol consumption have no significant mutual effect on cognitive function in elderly men in the community,while light to moderate alcohol consumption may be associated with the impairments in global cognitive and naming functions.

Objective:To investigate the plasma differential protein expressions between patients with Alzheimer's disease (AD) and normal controls, and to search plasma protein markers or protein combinations with screening or diagnostic significance.Methods:Plasma samples from 98 patients with dementia of Alzheimer type (DAT), 102 patients with mild cognitive impairment (MCI) and 101 normal controls (NC) were collected from Wuxi Mental Health Center and Shanghai Mental Health Center from 2016 to 2018.The expression levels of 50 kinds of plasma proteins in all plasma samples were detected by Milliplex MAP assays(xMAP).Analysis of variance, regression analysis, discriminant analysis, and ROC analysis on the data were performed using SPSS 20.0 software.Results:(1)Compared with the NC group, 26 plasma proteins were up-regulated and 4 proteins were down-regulated in DAT group, while 6 proteins were up-regulated and 4 proteins were down-regulated in MCI group(all P<0.05).Compared with the NC group, 6 proteins were upregulated in both MIC group and DAT group, which were clusterin(Clust) (613.41(278.89), 761.76(358.60), 473.01(321.73)), cystatin C(Cys C) (691.88(441.34), 852.28(551.75), 548.64(545.28)), transthyretin(TTR) (207.10(168.60), 220.95(151.20), 152.89(162.70)), complement factor H(Com FH) (331.67(218.37), 361.69(124.64), 225.79(236.82)), soluble intercellular adhesion molecule-1(sICAM1) (109.30(49.47), 137.21(50.36), 87.06(57.59), and apolipoprotein E(APOE) (79.33(78.13), 79.31(68.85), 54.88(67.34)).The serum amyloid P component(SAP) was downregulated in both DAT and MCI groups(121.23(311.31), 92.39(156.62), 125.00(242.82)) compared with NC group.(2)Three sets of protein combination were screened by differential analysis, regression analysis, and discriminant analysis, including 8 proteins, 9 proteins and 7 proteins, respectively.And SAP, angiotensin (AGT), osteopontin (OPN), and complement C4 (Com C4) were the compared with NC group most frequently selected protein.The screening correct rate of three protein combinations were respectively 67.4%-71.4% for AD, 82.4%-88.4% for DAT, and 60.6%-63.5% for MCI. Conclusions:A variety of plasma proteins such as Clust, Cys C, TTR, Com FH, sICAM1, APOE are upregulated, while SAP is downregulated in AD patients.These differential protein combinations can help with early diagnosis of dementia with Alzheimer type.SAP, AGT, OPN and Com C4 may be potential markers for early screening or diagnosis of AD.