Lots of patients with obstructive sleep apnea(OSA)are first recognized in dental institutions.In consideration of dental characteristics,we summarize advances in the application of screening methods for adult OSA patients based on oral examination,craniofacial structure,imaging examination,medical history,clinical symptoms,manifestation,populations at risk and questionnaires.Dental practitioners can screen and identify potential OSA patients,play a better role in the multidisciplinary of OSA,and help the pre-vention of OSA.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Lots of patients with obstructive sleep apnea(OSA)are first recognized in dental institutions.In consideration of dental characteristics,we summarize advances in the application of screening methods for adult OSA patients based on oral examination,craniofacial structure,imaging examination,medical history,clinical symptoms,manifestation,populations at risk and questionnaires.Dental practitioners can screen and identify potential OSA patients,play a better role in the multidisciplinary of OSA,and help the pre-vention of OSA.

Objective:To investigate the diagnostic value of serum Aspergillus fumigatus immunoglobulin G (IgG), bronchoalveolar lavage fluid (BALF) galactomannan antigen test (GM test) and combined detection of the two methods in chronic pulmonary aspergillosis (CPA). Methods:A total of 310 patients with suspected CPA who were hospitalized in Wuhan Pulmonary Hospital from January 2020 to December 2022 were screened. BALF-GM test and serum Aspergillus fumigatus IgG were detected. According to the inclusion and exclusion criteria, 151 confirmed or clinically diagnosed CPA patients were enrolled and 60 non-CPA cases were included as controls. The underlying diseases, clinical symptoms and imaging findings of the two groups were analyzed using case-control study. Statistical comparison was performed by chi-square test. The efficacies of BALF-GM test, serum Aspergillus fumigatus IgG test, and their combined detection for CPA were analyzed by receiver operating characteristic curve. Results:There were 130 confirmed cases and 21 clinically diagnosed cases among 151 patients with CPA, including 106 males (70.2%) with age of (54.6±15.5) years. The age of 60 non-CPA patients was (53.6±17.8) years, including 42 males (70.0%). The proportions of pulmonary tuberculosis, bronchiectasis and chronic obstructive pulmonary disease, and the incidence of hemoptysis in CPA group were 79.47%(120/151), 86.09%(130/151), 26.49%(40/151) and 43.71%(66/151), respectively, which were all higher than those in non-CPA group (10.00%(6/60), 25.00%(15/60), 8.33%(5/60) and 11.67%(7/60), respectively), and the differences were statistically significant ( χ2=86.14, 74.56, 8.44 and 19.48, respectively, all P<0.05). The proportion of interstitial lung disease in non-CPA group was 28.33%(17/60), which was higher than that in CPA group (2.65%, 4/151), and the difference was statistically significant ( χ2=31.61, P<0.001). The common imaging findings of CPA patients were pulmonary cavity (70.86%, 107/151), cavity inclusions (41.72%, 63/151) and lung damage (33.77%, 51/151). The specificity and sensitivity of serum Aspergillus fumigatus IgG for CPA diagnosis were 81.7% and 68.9%, respectively, and the area under the curve (AUC) was 0.753 (95% confidence interval (95% CI) 0.681 to 0.825, P< 0.001). The specificity and sensitivity of BALF-GM test were 76.7% and 67.5%, respectively, and the AUC was 0.724 (95% CI 0.649 to 0.800, P<0.001). The specificity and sensitivity of the two methods in series combined detection were 95.0% and 44.4%, respectively, and those of the two methods in parallel detection were 60.3% and 94.5%, respectively. The AUC of the combined diagnosis of CPA by the two methods was 0.843 (95% CI 0.783 to 0.903, P<0.001). Conclusions:Serum Aspergillus fumigatus IgG combined with BALF-GM test has a good diagnostic efficacy for CPA. The detection of serum Aspergillus fumigatus IgG is non-invasive and highly specific, which is beneficial to the early diagnosis and treatment of CPA.

Objective To establish the framework of a prediagnostic risk assessment system for outpatient dental care and to provide references for ensuring patient safety and improving the quality of medical services.Methods A total of 15 medical workers in a tertiary-care stomatology hospital in Sichuan Province were selected for qualitative interviews between October 2019 and December 2019.On the basis of the results of literature analysis and the interviews,an expert consultation form for prediagnostic risk assessment system for outpatient dental care was developed.Then,consultation of 10 experts in the field of oral health care and nursing was conducted between June 2020 and December 2020.Eventually,the framework of prediagnostic risk assessment system for outpatient dental care was formulated.Results Four themes emerged from the qualitative interviews.Firstly,prediagnostic risks of dental outpatients involved mainly syncope,cardiovascular emergencies,and other emergency medical risks.Secondly,medical risks came from three sources,patients,healthcare professionals,and the environment.Thirdly,medical professionals of outpatient dental care had limited awareness of the prediagnostic medical risks of patient.Fourthly,medical professionals of outpatient dental care showed inadequate response to and management of the prediagnostic medical risks of patient.The expert consultation helped finalize the Dental Outpatient Prediagnostic Risk Assessment Questionnaire,which included 3 primary indicators(namely,general information,medical history[including history of allergy],and medication assessment),12 secondary indicators(including patient demographics,patients'status upon admission,oral hygiene habits and special lifestyle habits,sensory disorders,special periods for female patients[ie,menstruation,pregnancy,and breastfeeding],allergy history[history of oral treatment-related allergies],past/present medical history,types of medication,route of medication administration,duration of medication administration,accuracy of medication administration,and adverse drug reactions),and 39 tertiary indicators.The effective recall rate of the expert consultation form was 100%,expert positivity was 100%,and the authority coefficient was 0.83.Kendall's harmony coefficient ranged from 0.808 to 0.839,which was statistically significant(P<0.001).Conclusion The framework of prediagnosis risk assessment system for outpatient dental care is found to be scientific and specific,but its applicability still needs further validation in clinical practice.

【Objective】 To explore the intention of voluntary blood donation in students from a middle vocational school in Jinhua and its influencing factors. 【Methods】 A total of 400 students were enrolled from a middle vocational school in Jinhua by convenience sampling, and a self-designed questionnaire was issued to each student to investigate the cognition, intention and attitude of voluntary blood donation. The influencing factors of voluntary blood donation intention were analyzed by Logistic regression. 【Results】 A total of 394 valid questionnaires(98.50%) were collected. For 394 surveyed students, the average score of cognition of voluntary blood donation was (7.27±2.69) points, and the overall rate of intention to voluntary blood donation was 21.32%. Logistic regression analysis equation consisted of family support, better cognition, feeling happy about blood donation and worrying about blood donation, with risk ratios(OR) as 31.78, 188.69, 26.27 and 0.01, respectively(all P<0.05). 【Conclusion】 Students from a middle vocational school showed poor congnition and intention of voluntary blood donation.Family support for voluntary blood donation, better cognition of voluntary blood donation and happiness for blood donation were positive factors, and the fear of blood donation was a negative factor.It is necessary to strengthen the publicity of blood donation among students in middle vocational school to improve their congnition and intention to voluntary blood donation.

Objective:To explore the relationship between the polymorphisms of SIRT1 and follicle-stimulating hormone receptor (FSHR) gene and ovarian function in women who underwent assisted reproductive technology (ART) and the differences between Mongolian and Han nationalities, so as to provide basis for the individualized treatment of ART assisted pregnancy. Methods:A retrospective cohort study was performed. The clinical data of 204 ART patients who visited the Reproductive Center of the Affiliated Hospital of Inner Mongolia Medical University from September 2019 to September 2021 were collected. There were 53 cases of Mongolian nationality and 151 cases of Han nationality. MassARRAY SNP genotyping technology was used to detect three sites, which were rs2236319 of SIRT1 and rs6165 and rs6166 of FSHR. SIRT1 was divided into three groups: AA group (wild type), AG group (heterozygous type) and GG group (mutant type); FSHR rs6165 was divided into TT group (wild type), AT group (heterozygous type), AA group (mutant type); FSHR rs6166 was divided into NN group (wild type), NS group (heterozygous type) and SS group (mutant type). The differences of genotype frequency and clinical and laboratory data were compared. Results:1) The allele frequencies and genotype frequencies of SIRT1 rs2236319, FSHR rs6165, and rs6166 loci were not statistically different in composition between Mongolian and Han ART female patient groups. There were no significant differences between Mongolian and Han ART women in terms of general clinical data and basal sex hormones and ovarian reserve function (all P>0.05). 2) There was a statistically significant difference in the number of eggs captured at the rs2236319 locus of the SIRT1 gene among the mutant GG group [18.5 (13.0, 32.8)], the AA group [13.0 (7.0, 20.0)] and the AG group [10.0 (5.0, 21.0), P=0.019]. 3) There was a statistically significant difference in the basal FSH levels at the rs6165 locus of the FSHR gene among the AA group [(7.45±2.73) U/L], the TT group [(5.97±2.23) U/L] and the TA group [(6.70±2.04) U/L, P=0.005]. The proportion of ovarian hyporesponsiveness among the AA group [29.6% (8/27)], the TT group [8.5% (8/94)] and the TA group [13.3% (11/83)] was statistically significant ( P=0.017). 4) The difference in basal FSH levels at the rs6166 locus of the FSHR gene among the SS group [(7.48±2.78) U/L], the NN group [(6.08±2.28) U/L] and the NS group [(6.61±1.99) U/L] was statistically significant ( P=0.016). The proportion of ovarian hyporesponsiveness among the SS group [37.0% (10/26)], the NN group [8.5% (8/99)] and the NS group [10.8% (9/79)] was statistically significant ( P=0.001). Conclusion:There were no significant differences between Mongolian and Han ART women in terms of general clinical data, basal sex hormones and ovarian reserve function. The gene polymorphism at rs2236319 of SIRT1 gene is associated with ovarian hyperresponsiveness. FSHR rs6165 and rs6166 gene polymorphisms are associated with ovarian hyporesponsiveness. There was no significant correlation between the three polymorphisms and the clinical pregnancy rate of ART.

Objective:To explore the relationship between the polymorphisms of SIRT1 and follicle-stimulating hormone receptor (FSHR) gene and ovarian function in women who underwent assisted reproductive technology (ART) and the differences between Mongolian and Han nationalities, so as to provide basis for the individualized treatment of ART assisted pregnancy. Methods:A retrospective cohort study was performed. The clinical data of 204 ART patients who visited the Reproductive Center of the Affiliated Hospital of Inner Mongolia Medical University from September 2019 to September 2021 were collected. There were 53 cases of Mongolian nationality and 151 cases of Han nationality. MassARRAY SNP genotyping technology was used to detect three sites, which were rs2236319 of SIRT1 and rs6165 and rs6166 of FSHR. SIRT1 was divided into three groups: AA group (wild type), AG group (heterozygous type) and GG group (mutant type); FSHR rs6165 was divided into TT group (wild type), AT group (heterozygous type), AA group (mutant type); FSHR rs6166 was divided into NN group (wild type), NS group (heterozygous type) and SS group (mutant type). The differences of genotype frequency and clinical and laboratory data were compared. Results:1) The allele frequencies and genotype frequencies of SIRT1 rs2236319, FSHR rs6165, and rs6166 loci were not statistically different in composition between Mongolian and Han ART female patient groups. There were no significant differences between Mongolian and Han ART women in terms of general clinical data and basal sex hormones and ovarian reserve function (all P>0.05). 2) There was a statistically significant difference in the number of eggs captured at the rs2236319 locus of the SIRT1 gene among the mutant GG group [18.5 (13.0, 32.8)], the AA group [13.0 (7.0, 20.0)] and the AG group [10.0 (5.0, 21.0), P=0.019]. 3) There was a statistically significant difference in the basal FSH levels at the rs6165 locus of the FSHR gene among the AA group [(7.45±2.73) U/L], the TT group [(5.97±2.23) U/L] and the TA group [(6.70±2.04) U/L, P=0.005]. The proportion of ovarian hyporesponsiveness among the AA group [29.6% (8/27)], the TT group [8.5% (8/94)] and the TA group [13.3% (11/83)] was statistically significant ( P=0.017). 4) The difference in basal FSH levels at the rs6166 locus of the FSHR gene among the SS group [(7.48±2.78) U/L], the NN group [(6.08±2.28) U/L] and the NS group [(6.61±1.99) U/L] was statistically significant ( P=0.016). The proportion of ovarian hyporesponsiveness among the SS group [37.0% (10/26)], the NN group [8.5% (8/99)] and the NS group [10.8% (9/79)] was statistically significant ( P=0.001). Conclusion:There were no significant differences between Mongolian and Han ART women in terms of general clinical data, basal sex hormones and ovarian reserve function. The gene polymorphism at rs2236319 of SIRT1 gene is associated with ovarian hyperresponsiveness. FSHR rs6165 and rs6166 gene polymorphisms are associated with ovarian hyporesponsiveness. There was no significant correlation between the three polymorphisms and the clinical pregnancy rate of ART.

Objective:To study the effect of Wuzhi capsules on tacrolimus trough concentration in kidney transplant recipients with different CYP3A5 genotypes.Methods:From June 2015 to October 2019, 162 patients who underwent renal transplantation for the first time were retrospectively analyzed. The patients were divided into two groups, combined and uncombined, according to whether combined with Wuzhi capsules. There were 81 cases in the uncombined group (55 males and 26 females), and 81 in the combined group (62 males and 19 females). There was no significant difference between the two groups( P=0.219). The ages of the uncombined group and the combined group were (39.26±11.91) years old and (37.21±10.88) years old ( P=0.103), the weights were (62.39±11.64) kg and (66.18±13.89)kg ( P=0.298), systolic blood pressure were (147.28±20.24) mmHg and (145.00±16.42) mmHg (1 mmHg=0.133 kPa)( P=0.276), diastolic blood pressure were (92.25±13.87) mmHg and (92.20±12.53) mmHg ( P=0.886), alanine aminotransferase were (12.24±8.59) U/L and (17.06±13.11) U/L ( P=0.015), aspartate aminotransferase were (17.76±9.12) U/L and (16.57±8.37) U/L ( P=0.463), fasting blood glucose were (8.70±3.48) mmol/L and (7.18±2.74)mmol/L ( P=0.006), hemoglobin were (98.96±17.53) g/L and (101.05±18.67) g/L ( P=0.789), creatinine were (665.22±296.55) μmol/L and (797.32±279.32) μmol/L ( P=0.007), estimated glomerular filtration rate were (11.47±14.11) ml/(min·1.73m 2) and (8.85±3.71) ml/(min·1.73m 2) ( P=0.130)in the kidney transplant recipients before surgery. Among the 162 cases in this study, there were 86 cases (53.09%) of CYP3A5*1*3 genotype, 17 cases (10.49%) of CYP3A5*1*1 genotype, 59 cases (36.42%) of CYP3A5*3*3 genotype, and the minimum allele frequency of CYP3A5*1 was 37.04%. In the uncombined group, CYP3A5*1*3 genotype 39 cases (48.15%), CYP3A5*1*1 genotype 5 cases (6.17%), and CYP3A5*3*3 genotype 37 cases (45.68%). In the combined group, CYP3A5*1*3 genotype 47 cases (58.02%), CYP3A5*1*1 genotype 12 cases (14.81%), and CYP3A5*3*3 genotype 22 cases (27.16%), with statistically significant differences in the two groups ( P=0.024). The patients were treated with a triple immunosuppressive regimen (tacrolimus+ mycophenolate mofetil+ glucocorticoid) based on tacrolimus [initial dose: 0.15-0.30 mg/(kg·d)], combination of Wuzhi capsules in the combination group (11.25 mg, twice a day). The trough concentration of tacrolimus was detected by enzyme-linked immunosorbent assay, compare the difference in the trough concentration of tacrolimus between the two groups. The relationship between the effect of Wuzhi capsules and CYP3A5 gene polymorphism was compared, and compare the changes before and after the application of CYP3A5 genotype combined with Wuzhi Capsules. The influencing factors of tacrolimus trough concentration were analyzed by multiple linear regression. Results:In the combined with Wuzhi capsules, the dose corrected trough concentration (C 0/D) of tacrolimus was higher than that in patients without Wuzhi capsules, and the extent of increase was related to genotype. The C 0/D of tacrolimus in patients with CYP3A5*3*3 genotype in the combination and non-combination groups were (12.15±2.95) (ng·ml -1/0.1mg·kg -1·d -1) and (9.99±2.33) (ng·ml -1/0.1mg·kg -1·d -1) ( P=0.004), CYP3A5*1*3 genotype were (11.11±3.20) (ng·ml -1/0.1mg·kg -1·d -1) and (6.86±1.62) (ng·ml -1/0.1mg·kg -1·d -1) ( P<0.001), and there were significant difference. However, CYP3A5*1*1 genotype were(8.29±2.64) (ng·ml -1/0.1mg·kg -1·d -1) and (6.16±2.87) (ng·ml -1/0.1mg·kg -1·d -1) ( P=0.160), there was no significant difference. The tacrolimus C 0/D of the combined group before and after the Wuzhi capsule were as follows: CYP3A5*3*3 genotype: (7.18±2.33)(ng·ml -1/0.1mg·kg -1·d -1) and (13.33±3.09) (ng·ml -1/0.1mg·kg -1·d -1) ( P<0.001); CYP3A5*1*3 genotype: (5.14±2.14) (ng·ml -1/0.1mg·kg -1·d -1) and (10.61±3.20) (ng·ml -1/0.1mg·kg -1·d -1) ( P<0.001); CYP3A5*1*1 genotype: (5.17±3.75) (ng·ml -1/0.1mg·kg -1·d -1) and (8.31±2.74) (ng·ml -1/0.1mg·kg -1·d -1)( P=0.002), and the differences were statistically significant. The results of multiple linear regression showed that the combination of Wuzhi capsules (β=0.508, P<0.001) and CYP3A5 genotype(CYP3A5*1*3 and CYP3A5*3*3: β=-0.361, P<0.001; CYP3A5*1*1 and CYP3A5*3*3: β=-0.425, P<0.001)could influence the trough concentration. The sex (β=-0.100, P=0.124) and age (β=-0.003, P=0.967) of renal transplant recipients had no statistical significance to tacrolimus C 0/D. Conclusions:In the renal transplant patients, CYP3A5 genotype and combined use of Wuzhi capsules are the main factors affecting tacrolimus C 0/D. In order to achieve the expected trough concentration as soon as possible, the interaction between CYP3A5 genotypes and drug combination should be considered.