Objective To provide a scientific basis for vector prevention and control in port areas, vector monitoring has been conducted continuously to characterize the composition, density, and seasonal fluctuations of vectors across 21 port-areas of Shandong province from 2017 to 2023. Methods In accordance with the Regional Vector Monitoring Plan for Frontier Ports, vector surveillance of mosquitoes, flies, cockroaches, rodents, and other disease vectors was performed. Data were analyzed to describe vector community composition and identify seasonal fluctuations. Results A total of 601 rodents belonging to 1 family, 4 genera, and 4 species were captured. Three dominant rodent species inhabit port areas. In addition, 88 104 mosquitoes were captured and classified into 3 subfamilies, 4 genera, and 12 species; 38 959 flies were trapped and classified into 8 families,31 genera, and 51 species, including 9 dominant fly species in port-areas; and 54 672 captured cockroaches were classified into 2 families,4 genera, and 4 species, with Blattella germanica as the dominant species. Conclusions Significant vector community changes(P＜0.005)have been identified after the epidemic. To improve the pertinence and efficacy of port health quarantine work, continuous and strong attention should be paid to vector compositions and population densities at Shandong ports.

With the rapid evolution of medical information technology, internet hospitals had become an integral part of China′s healthcare service system and could play a unique role in multidisciplinary diagnosis and treatment (MDT). In 2023, Nanjing Drum Tower Hospital built a smart service platform for MDT based on its internet hospital under the design concept of " global collaboration, process re-engineering, and smart empowerment", and officially launched in November of the same year. The platform included a five-tier architectur: user interaction, application services, data management, system integration and infrastructure, and embeds functional modules such as consultation management, an AI-assisted engine and a workflow engine. This platform covered Nanjing Drum Tower Hospital Group members, implemented an online-offline integrated, end-to-end workflow (pre-intra-post consultation). It realized the integration and utilization of high-quality medical resources across regions and institutions, and improved the quality and efficiency of MDT. As of December 2024, the platform had covered 30 specialties and completed 75 MDT consultations. The consultation cycle had been shortened from the traditional MDT mode of 14.2 days to 2.4 days, effectively reducing the number of patients traveling to and from the hospital. This platform had expanded the business scope of internet hospitals, improved the utilization rate of medical resources, and could provide references for other public hospitals in China to optimize the MDT service mode.

Objective To examine the changing prevalence and antimicrobial resistance profiles of Burkholderia cepacia in 52 hospitals across China from 2015 to 2021.Methods A total of 9 261 strains of B.cepacia were collected from 52 hospitals between January 1,2015 and December 31,2021.Antimicrobial susceptibility of the strains was tested using Kirby-Bauer method or automated antimicrobial susceptibility testing systems according to a unified protocol.The results were interpreted according to the breakpoints released in the Clinical & Laboratory Standards Institute(CLSI)guidelines(2023 edition).Results A total of 9 261 strains of B.cepacia were isolated from all age groups,especially elderly patients.The proportion was 11.1％(1 032 strains)in children,significantly lower than the proportion in adults.About half(46.5％,4 310/9 261)of the strains were isolated from patients at least 60 years old and 42.3％(3 919/9 261)of the strains were isolated from young adults.Most isolates(71.1％)were isolated from sputum and respiratory secretions,followed by urine(10.7％)and blood samples(8.1％).B.cepacia isolates were highly susceptible to the five antimicrobial agents recommended in the CLSI M100 document(33rd edition,2023).B.cepacia isolates showed relatively higher resistance rates to meropenem and levofloxacin.However,the resistance rates to ceftazidime,trimethoprim-sulfamethoxazole,and minocycline remained below 8.1％.The percentage of B.cepacia strains resistant to levofloxacin was the highest compared to other antibiotics in any of the three age groups(from 12.4％in the patients＜18 years old to 20.6％in the patients aged 60 years or older).Conclusions B.cepacia is one of the clinically important non-fermenting gram-negative bacteria.Accurate and timely reporting of antimicrobial susceptibility test results and ongoing antimicrobial resistance surveillance are helpful for rational prescription of antimicrobial agents and proper prevention and control of nosocomial infections.

Although teniposide(VM26)is widely used in the treatment of lymphoma,its poor water sol-ubility,low bioavailability and systemic toxicities still limit its clinical application.Nano-delivery systems are effective in increasing the bioavailability and reducing the toxicity of VM26,but there is an urgent need to overcome the problem of its non-specific targeting.Therefore,in this paper,we designed and constructed a hyaluronic acid-modified teniposide-targeted nano-delivery system(VM26-TNDS),and characterised its drug encapsulation rate,particle size and zeta potential.We also investigated the effects of VM26-TNDS on B-cell lymphoma cells with different expression of CD44 receptor,in terms of cellular targeting,inhibitory effect of proliferation,and induction of apoptosis and necrosis.The results showed that the drug encapsulation efficiency of VM26-TNDS exceeded 85％,and its liquid formulation could be stably stored at 4 ℃ for more than 6 months without precipitation.Based on CD44 receptor expression,Granta-519(high expression),Raji(medium-low expression)and SU-DHL-4(almost no expression)were screened for cellular experiments.Compared with VM26-NDS,the targeted modification could effec-tively reduce the uptake of VM26-TNDS by RAW264.7 and increase the uptake of VM26-TNDS by CD44 receptor-expressing lymphoma cells.The inhibitory proliferative effect and apoptotic necrosis-inducing a-bility of VM26-TNDS were stronger than those of VM26-NDS for Granta-519 and Raji cells,whereas there was no significant difference in the inhibitory effect on proliferation and ability to induce apoptosis and necrosis between VM26-NDS and VM26-TNDS in SU-DHL-4 cells,reflecting the targeting advantage for VM26-TNDS,as expected.However,its toxic effect on B-cell lymphoma cells only reflected the targeting advantage at some concentrations(0.25 μmol/L and 0.5 μmol/L),which met the expectation.The a-bove results indicate that a teniposide-targeted nano-delivery system,VM26-TNDS,has been successfully prepared in this study.VM26-TNDS improves the delivery efficiency of VM26 by targeting human B-cell lymphoma cells expressing the CD44 receptor,thus killing human B-cell lymphoma cells more effectively and overcoming the problem of non-specific targeting in drug delivery to improve the therapeutic effect.Its biological therapeutic effects and mechanisms still need to be proved by more in vitro and in vivo ex-perimental evidence.

Objective To summarize the changing prevalence of carbapenem resistance in Enterobacterales based on the data of CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021 for improving antimicrobial treatment in clinical practice.Methods Antimicrobial susceptibility testing was performed using a commercial automated susceptibility testing system according to the unified CHINET protocol.The results were interpreted according to the breakpoints of the Clinical & Laboratory Standards Institute(CLSI)M100 31st ed in 2021.Results Over the seven-year period(2015-2021),the overall prevalence of carbapenem-resistant Enterobacterales(CRE)was 9.43％(62 342/661 235).The prevalence of CRE strains in Klebsiella pneumoniae,Citrobacter freundii,and Enterobacter cloacae was 22.38％,9.73％,and 8.47％,respectively.The prevalence of CRE strains in Escherichia coli was 1.99％.A few CRE strains were also identified in Salmonella and Shigella.The CRE strains were mainly isolated from respiratory specimens(44.23±2.80)％,followed by blood(20.88±3.40)％and urine(18.40±3.45)％.Intensive care units(ICUs)were the major source of the CRE strains(27.43±5.20)％.CRE strains were resistant to all the β-lactam antibiotics tested and most non-β-lactam antimicrobial agents.The CRE strains were relatively susceptible to tigecycline and polymyxins with low resistance rates.Conclusions The prevalence of CRE strains was increasing from 2015 to 2021.CRE strains were highly resistant to most of the antibacterial drugs used in clinical practice.Clinicians should prescribe antimicrobial agents rationally.Hospitals should strengthen antibiotic stewardship in key clinical settings such as ICUs,and take effective infection control measures to curb CRE outbreak and epidemic in hospitals.

Objective To characterize the changing species distribution and antibiotic resistance profiles of respiratory isolates in hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Methods Commercial automated antimicrobial susceptibility testing systems and disk diffusion method were used to test the susceptibility of respiratory bacterial isolates to antimicrobial agents following the standardized technical protocol established by the CHINET program.Results A total of 589 746 respiratory isolates were collected from 2015 to 2021.Overall,82.6％of the isolates were Gram-negative bacteria and 17.4％were Gram-positive bacteria.The bacterial isolates from outpatients and inpatients accounted for(6.0±0.9)％and(94.0±0.1)％,respectively.The top microorganisms were Klebsiella spp.,Acinetobacter spp.,Pseudomonas aeruginosa,Staphylococcus aureus,Haemophilus spp.,Stenotrophomonas maltophilia,Escherichia coli,and Streptococcus pneumoniae.Each microorganism was isolated from significantly more males than from females(P＜0.05).The overall prevalence of methicillin-resistant S.aureus(MRSA)was 39.9％.The prevalence of penicillin-resistant S.pneumoniae was 1.4％.The prevalence of extended-spectrum β-lactamase(ESBL)-producing E.coli and K.pneumoniae was 67.8％and 41.3％,respectively.The overall prevalence of carbapenem-resistant E.coli,K.pneumoniae,Enterobacter cloacae,Pseudomonas aeruginosa,and Acinetobacter baumannii was 3.7％,20.8％,9.4％,29.8％,and 73.3％,respectively.The prevalence of β-lactamase was 96.1％in Moraxella catarrhalis and 60.0％in Haemophilus influenzae.The H.influenzae isolates from children(＜18 years)showed significantly higher resistance rates to β-lactam antibiotics than the isolates from adults(P＜0.05).Conclusions Gram-negative bacteria are still predominant in respiratory isolates associated with serious antibiotic resistance.Antimicrobial resistance surveillance should be strengthened in clinical practice to support accurate etiological diagnosis and appropriate antimicrobial therapy based on antimicrobial susceptibility testing results.

AIM To study the chemical constituents from Inula japonica Thunb.and their anti-asthmatic activity.METHODS Separation and purification were performed using silica gel and Sephadex LH-20,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The effect of compounds on the release rate of β-Hex was evaluated by substrate coloration method.RESULTS Twenty-three compounds were isolated and identified as dehydrodontic acid(1),vitexin(2),alternariol(3),globuxanthone(4),1,3,6,7-tetrahydroxyxanthone(5),hydroxyhydrolapachol(6),isoscopoletin(7),elephanmollen(8),benzoylcholine(9),hoconobiflavone(10),clovandiol(11),hydroxydihydrobovolide(12),5,7-dihydroxycoumarin(13),scopoletin(14),orlichenol glucoside(15),urolignoside(16),9-angeloyloxythymol(17),6,3′,4′-trihydroxyaurone(18),flufuran(19),sweroside(20),guajadial(21),5,7,4′-trimethoxy-4-phenylcoumarin(22),dibutylphthalate(23).After intervention with compounds 9 and 16,the release rates of β-Hex were(56.64±2.37)％and(58.07±2.29)％,respectively.CONCLUSION Compounds 1-23 are isolated from Ⅰ.japonica for the first time.Compounds 9 and 16 have anti-asthmatic activity.

Objective:To retrospectively analyze the efficacy and safety of different radiotherapy doses in treating esophageal squamous carcinoma(ESCC)patients aged ≥80 years.Methods:This retrospective study collected clinical data from ESCC patients aged ≥80 years who underwent radiotherapy at the Fourth Hospital of Hebei Medical University from January 2016 to September 2021.Observation variables included overall survival(OS), progression free survival(PFS), complete response(CR), partial response(PR), stable disease(SD), progressive disease(PD), and adverse reactions.Survival rates were estimated using the Kaplan-Meier method and compared via log-rank tests.Cox regression models were employed for multivariate analysis.Results:A total of 165 patients who met the enrollment criteria were included in this study, including 88(88/165, 53.3%)males and 77(77/165, 46.7%)females, age 80 to 100 years(median age 83 years), 66 cases(66/165, 40.0%)in the radiotherapy dose ≥60 Gy group and 99 cases(99/165, 60.0%)in the <60 Gy group.Of the 165 patients, the effective rate was 71.5%(118/165).The median overall survival(OS)of the whole group was 19.0 months, The median Progression Free Survival(PFS)for the whole group was 13 months.The results showed that radiotherapy dose, lesion length, Nutritional Risk Index(NRI), eating condition, recurrence/progression and chemotherapy were factors influencing OS.The survival of patients in the ≥60 Gy group, ≤5 cm group, well-nourished group(NRI ≥45)group, soft diet and general diet group and combined chemotherapy group is better.Cox multivariate analysis revealed that radiotherapy, dose eating condition and the lesion length were independent prognostic factors for OS.The OS rate of the radiation therapy group with a dose of ≥ 60 Gy was better than that of the<60 Gy group( P=0.001), the OS of the general or soft diet group was better than that of the semi liquid or liquid diet group( P=0.008), and the OS of the lesion length ≤ 5 cm group was better than that of the>5 cm group( P=0.020).The incidence rates of radiation-induced esophagitis, myelosuppression, radiation pneumonia, and gastrointestinal reactions in the entire group were 60.0%(99/165), 12.1%(20/165), 22.4%(37/165), and 14.5%(24/165), respectively.51.5%(85/165)of the group experienced local recurrence, 10.3%(17/165)had distant organ metastasis, and 9.1%(15/165)had non regional lymph node metastasis.As of the follow-up date, there were a total of 99 deaths in the entire group. Conclusions:For patients aged 80 years or older with esophageal cancer, higher radiation doses, better feeding and nutritional status have more beneficial for prolonged survival.Local recurrence remains the main reason for treatment failure in elderly patients with esophageal cancer.

With the rapid evolution of medical information technology, internet hospitals had become an integral part of China′s healthcare service system and could play a unique role in multidisciplinary diagnosis and treatment (MDT). In 2023, Nanjing Drum Tower Hospital built a smart service platform for MDT based on its internet hospital under the design concept of " global collaboration, process re-engineering, and smart empowerment", and officially launched in November of the same year. The platform included a five-tier architectur: user interaction, application services, data management, system integration and infrastructure, and embeds functional modules such as consultation management, an AI-assisted engine and a workflow engine. This platform covered Nanjing Drum Tower Hospital Group members, implemented an online-offline integrated, end-to-end workflow (pre-intra-post consultation). It realized the integration and utilization of high-quality medical resources across regions and institutions, and improved the quality and efficiency of MDT. As of December 2024, the platform had covered 30 specialties and completed 75 MDT consultations. The consultation cycle had been shortened from the traditional MDT mode of 14.2 days to 2.4 days, effectively reducing the number of patients traveling to and from the hospital. This platform had expanded the business scope of internet hospitals, improved the utilization rate of medical resources, and could provide references for other public hospitals in China to optimize the MDT service mode.

The disease burden of valvular heart disease (VHD) is increasing with the aging of our society. This paper introduces the disease characteristics of VHD, the current status and problems on postoperative cardiac rehabilitation in VHD patients, the difficulties and solutions in the development of postoperative cardiac rehabilitation programs for VHD patients, and proposes future research directions, with a view to providing a reference for carrying out postoperative cardiac rehabilitation in VHD patients.