Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Objective:To explore the role and mechanism of neurotrophin-3(NT-3)in promoting neurological func-tion recovery after cerebral ischemia-reperfusion injury in rats.Methods:Twenty-four SD rats were randomly divided into sham operation group(Sham),middle cerebral artery occlusion/reperfusion(MCAO/R)group,and MCAO/R+NT-3 group.The neurological function scores of rats in each group were evaluated using the modified Garcia score.Western Blot was used to detect the expression of NT-3 and LC3B in brain tissues of rats.Culture dishes with the same density of neurons were randomly divided into normal group(Normal),oxygen-glucose deprivation(OGD)group,OGD+NT-3 group,OGD+NT-3+PF-06273340(TrkC inhibitor)group,OGD+NT-3+ZSTK474(PI3K inhibitor)group,and OGD+NT-3+CCT128930(AKT inhibitor)group.Western Blot was used to detect the expression of TrkC,the phosphorylation of PI3K/AKT,and LC3B in neurons.The morphological changes of neurons and the phenomenon of neuronal autophagy were observed using autophagy-specific fluorescent staining.Results:The animal experiment found that the expression of NT-3 increased in the brain tissue with ischemia-reperfusion injury(P＜0.05),and after the treatment with exogenous NT-3,the modified Garcia score increased(P＜0.05),and the level of autophagy weakened(P＜0.05).The cell experiment found that NT-3 can inhibit neuronal autophagy under ischemic hypoxia and maintain the neuronal morphology to the maximum extent.After using PF-06273340,the expression of p-PI3K and p-AKT de-creased(P＜0.05).After using ZSTK474 and CCT128930,the autophagy-inhibiting effect of NT-3 weakened(P＜0.05).Conclusion:NT-3 inhibits autophagy via the PI3K/AKT signaling pathway to maintain neuronal survival,thereby promoting the recovery of neurological function after cerebral ischemia-reperfusion injury in rats.

ObjectiveTo investigate the association of lipid ratios with diabetes and pre-diabetes in residents aged 35-75 years in Changzhou City. MethodsA multistage whole-group random sampling method was used to survey permanent residents aged 35-75 years in Tianning and Wujin districts of Changzhou City， and the study data were obtained by questionnaires， physical examination and laboratory tests. The relationship between lipid ratios and diabetes and pre-diabetes was analyzed by dichotomous logistic regression method. ResultsThe prevalence of diabetes in the surveyed population in Changzhou was 18.69%， and the prevalence of pre-diabetes was 10.53%. In the total population， the risk of pre-diabetes was significantly increased in the highest TC/HDL-C， TG/HDL-C and LDL-C/HDL-C groups， by 68%， 93% and 38%， respectively； the risk of diabetes was also significantly increased in the highest TC/HDL-C， TG/HDL-C and LDL-C/HDL-C groups， by 105%， 149% and 78%， respectively. The risk of diabetes was also significantly increased in the highest TC/HDL-C， TG/HDL-C and LDL-C/HDL-C groups， by 105%， 149% and 78%， respectively. All three lipid ratios increased in women compared to men， leading to a stronger association with increased risk of diabetes and pre-diabetes. ConclusionLipid ratios TC/HDL-C， TG/HDL-C， and LDL-C/HDL-C were correlated with the risk of diabetes and pre-diabetes in people aged 35-75 years， with TG/HDL-C having the strongest association with diabetes and pre-diabetes， and is expected to be a key predictor for assessing the development of diabetes.

Objective To establish a long-term survival model of deep hypothermic circulatory arrest (DHCA) in rats,which could contribute to the research of organ damage mechanism and clinical treatments related to DHCA.Methods Twenty Sprague-Dawley rats were randomly (random number) divided into the sham group (n=10) and DHCA group (n=10).After anesthesia,a 20 G catheter was cannulated in the tail artery for arterial inflow,a multiorificed catheter in the right jugular vein for venous drainage,and a 24G catheter in the branch of left femoral artery for artery blood pressure monitoring.Rats in the DHCA group underwent DHCA procedure for 40 min after brain temperature cooled to 18℃,then rewarmed for 40 min,till the brain temperature were above 34℃.Rats in the sham group were cannulated but did not undergo cardiopulmonary bypass (CPB).Hemodynamic parameters and blood gas analysis were measured for 5 times (pre-CPB,15 min after CPB,10 min after rewarming,40 min after rewarming,and 30 min after CPB).Results One rat in the DHCA group died,and the rest rats survived.The lactate level in the DHCA group after rewarming during operation was significantly higher than that in the sham group (7.84 mmol/L vs 1.93 mmol/L,P＜0.05).Conclusions In this study,40-min DHCA model in rats is characterized by safe and long-term survival.

Objective To investigate the relationship between peripheral blood mtDNA content and acute coronary syndrome. Methods A total of 244 patients who received coronary angiography(CAG)was enrolled in this study. They were divided into acute coronary syndrome(ACS)group(n=183)and control group(n=61)ac-cording to the CAG results. A quantitative real-time PCR-based method was used to measure relative content of mtDNA in peripheral blood. According to lesion blood vessel counts ,ACS patients were divided into single lesion group,double lesion group and three lesions group. Gensini score was used to quantitatively evaluate the severity of coronary stenotic lesions. Then we analyzed the relationship of mitochondrial DNA content with the lesion counts and the Gensini score. Results The ACS group had a lower mtDNA content ,as compared to controls (P <0.001).The lesion blood vessel count and mtDNA content in the single ,double and three vascular lesions group were all significanlty lower than that of the control group(P<0.05)and that of the double,three vascular lesions group were both significantly lower than that of the single vascular lesion group(P<0.05). According to the Gensi-ni score,all patients were divided into four groups,where with mtDNA content was decreased with the increase of the Gensini score(P < 0.01). The linear regression analysis showed that Gensini score was negatively correlated with mtDNA content(r=-0.644,P<0.001). ROC curve analysis showed that the area under the curve of mtDNA content for ACS diagnosis was 0.855(P<0.001),with the sensitivity and specificity of 0.756 and 0.833,respec-tively. Conclusion MtDNA content is closely associated with ACS and the Gensini score ,the latter indicating the severity of coronary stenotic lesions. MtDNA content detection has its value in the diagnosis of ACS.

This study was aimed to investigate the effect of traditional Chinese medicine (TCM) compound "Ji-Sui-Kang (JSK)" on the differentiation of neural stem cells (NSCs).Drug serum of JSK was prepared.The primary NSCs were isolated and cultured.NSCs were identified.Fetal bovine serum (FBS) was used to induce differentiation of NSCs.Different doses of drug serum of JSK was added to intervene the differentiation.There were the high-,medium-,and low-dose group.The blank control group was also set.The β Ⅲ-tubulin and GFAP were used to detect the differentiation of NSCs.And then,it was compared with the control group without drug serum.Positive cells ofβ m-tubulin and GFAP in different visual fields were counted.And the percentage of positive cells in the total number of cells was calculated.Fluorescence microscope was used to conduct quantitative fluorescence experiments.The results showed that the cultured neurospheres were expressed of Nestin protein.The percentage ofβⅢ-tubulin positive cells in the high-,medium-and low-dose group of drug serum of JSK was significantly higher than that in the control group (P＜0.05).The percentage of GFAP positive cells in the high-,medium-and low-dose groups of drug serum of JSK was significantly lower than that in the control group (P＜0.05).And the high-dose group of drug serum of JSK was statistically significant compared with the middle-and low-dose group of drug serum of JSK (P＜0.01).It was concluded that TCM compound JSK promoted thedifferentiation of NSCs intoβⅢ-tubulin positive cells.It provided a basis for treatment of SCI with TCM.

Objective:To explore the effects of body mass index (BMI) and gender on primary lung cancer 18F-FDG uptake param-eters, standardized uptake value (SUV), and standard uptake value of lean body mass (SUL). Methods:Data of 50 patients with prima-ry lung cancer confirmed by 18F-FDG positron emission tomography (PET)/computed tomography (CT) were retrospectively analyzed. AW4.6 workstation was employed to measure the SUVmean and SUVmax. Meanwhile, PETVCAR (PET Volume Computed Assisted Reading, GE Healthcare) software was used to automatically measure the SULmean, SULmax, and SULpeak. The SUVmean, SUV-max, SULmean, and SULmax of the liver (central region of the right lobe) were also measured automatically by PETVCAR. Afterward, T/N ratios (lesion SUVmax/liver SUVmean, lesion SULmax/liver SULmean, and lesion SULpeak/liver SULmean) of the lung cancer lesions were calculated. Correlations of the 18F-FDG metabolic parameters with BMI and gender of the patients were analyzed. Results:Liver SUVmean and SUVmax demonstrated significant positive correlations with BMI in all the patients (γ=0.38 and 0.36, P<0.05), and the SUVmean and SUVmax were positively correlated with BMI in male and female groups (γ=0.47 and 0.44, P<0.05), respective-ly. By contrast, no correlation existed between the liver SULmean and SULmax and BMI (P>0.05). No significant correlation was not-ed between the SUVmean, SUVmax, SULmean, SULmax, and SULpeak of the lung cancer lesions and BMI (P>0.05). The correlation trend is the same as that in different gender groups. Only the SUVmax T/N ratio of the lung cancer lesions showed a significant nega-tive correlation with BMI (γ=?0.29, P<0.05). The T/N ratios did not correlate with BMI in the different gender groups (P>0.05). Con-clusion:Patient BMI and gender mainly affect SUV values, particularly SUVmax, by contrast, patient BMI and gender did not signifi-cantly influence SUL and T/N ratio (SUL). Hence, SUL can be more suitable to quantitatively analyze and assess treatment response ob-jectively. This result will be helpful to the clinical application and promotion of PERCIST, which evaluates treatment response mainly by SUL.

OBJECTIVETo investigate the diagnostic value of (18)F-FDG PET-CT imaging in primary extranodal lymphoma.

METHODSA retrospective analysis of 139 clinically suspected primary extranodal lymphoma patients examined by PET-CT and confirmed by biopsies was performed. Considering the pathological diagnosis as the gold standard, PET-CT imaging of all patients was compared with CT and PET to evaluate the efficacy of 18F-FDG PET-CT in detection of primary extranodal lymphoma. The maximal standardized uptake value (SUVmax) from primary extranodal lymphoma patients was compared, and the data were analyzed by χ² test.

RESULTSOf the total 139 analyzed cases, 128 patients were confirmed to have primary extranodal lymphoma. The sensitivity, specificity and positive rate of PET-CT were 82.8%, 81.8% and 82.7%, respectively, that of CT were 65.6%, 72.7% and 66.2%, and that of PET were 78.9%, 36.4% and 82.0%, respectively. The sensitivity and accuracy of PET-CT were better than that of CT (χ²=9.881, 10.006; P=0.003, 0.002). The specificity of PET-CT were better than that of PET (χ²=4.487, P=0.034). In the gastrointestinal lymphoma, the sensitivity of PET-CT were better than that of CT (χ²=5.110, P=0.024). In the head and neck lymphoma, the sensitivity of PET-CT were better than that of CT (χ²=5.278, P=0.022). In the diffuse large B-cell lymphoma, the sensitivity of PET-CT were better than that of CT (χ²=8.711, P=0.003). The SUV max of mucosa-associated lymphoma was significantly different from that of diffuse large B-cell lymphoma and natural killer/T-cell lymphoma (7.4±4.6 vs 15.8±10.6, P=0.032; 7.4±4.6 vs 13.6±7.1, P=0.046), respectively.

CONCLUSION18F-FDG PET-CT imaging is important in the diagnosis of primary extranodal lymphoma, but the differential diagnosis with other disease is important, and the result should be combined with multiple biopsies.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Fluorodeoxyglucose F18 ; Humans ; Lymphoma ; diagnosis ; diagnostic imaging ; Male ; Middle Aged ; Positron-Emission Tomography ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Young Adult

ObjectiveTo investigate the electrocardiogram (ECG) characteristics of patients with early repolarization variant (ERV).Methods One hundred and six patients diagnosed of ERV based on clinical and ECG and the healthy control group of 100 patients were analyzed and ECG features and ERV site were compared between these two groups.Results The mean heart rate( [ 68.6 ± 8.4 ] beats/min vs [ 74.8 ± 12.6 ]beats/min),QRS time( [95 ± 10] ms,[96 ± 11] ms vs[ 388 ± 12 ] ms,[379 ± 14]ms),QT dispersion and Tp-Te ( [ 80.4 ± 7.6 ] ms vs [ 78.5 ± 8.3 ] ms) were compared respectively between ERV group and control group and there was no significant difference (P ＞ 0.05).The occurrence of J wave in inferior leads was 67.9％,15.1％for the side wall leads,and 17.0％ for the chest leads,thus inferior wall leads had higher incidence than other hads relativelv in ERV ( P ＜ 0.01 ).Conclusion ERV exhibits more occurrence in inferior wall leads.