Objective:To evaluate the reliability and validity of the Mandarin version of the patient-rated tennis elbow evaluation(PRTEE)for patients with tennis elbow.Method:With the permission of the author of the original questionnaire,the PRTEE was translated into Chi-nese following current international procedures.A total of 100 subjects were included in the study,and were assessed using the visual analogue scale(VAS),the Disabilities of the Arm,Shoulder,and Hand(DASH)ques-tionnaire,and PRTEE.A second assessment using the PRTEE was completed with 75 participants after one week.The internal consistency of the scale was evaluated using Cronbach's alpha coefficient,and the test-re-test reliability was evaluated using the intraclass correlation coefficient(ICC).The construct validity of the Mandarin version of PRTEE scale was examined by analyzing correlation with the Chinese version of VAS and DASH scores using Pearson's correlation coefficient.The ceiling or floor effect was determined by explor-atory analysis.Result:The Cronbach's alpha coefficient of PRTEE total score,pain and function subscales were 0.947,0.872,and 0.927,respectively.The ICC values for test-retest reliability of PRTEE total score,pain,and func-tion subscales were 0.988、0.975,and 0.980,respectively.The correlation coefficient between PRTEE total score and its two subscales and VAS ranged from 0.838 to 0.920(P＜0.01),indicating a strong correlation.The correlation coefficient between the PRTEE total score and two subscales,the DASH total score and two di-mensions ranged from 0.704 to 0.893(P＜0.01),indicating a strong correlation.There were no subjects who re-ceived the lowest or highest scores,indicating that the scale had no ceiling or floor effects.Conclusion:The Mandarin version of PRTEE demonstrates good reliability and validity,with no evidence of ceiling or floor effect.It is suitable for evaluating tennis elbow in Mandarin-speaking patients.

Objective:To investigate the neuroprotective efficacy of scutellarin(Scu)against cerebral ischemia-reperfusion(CIRI)injury in rats,with a focus on its regulatory mechanisms involving the CX3CL1/CX3CR1-PI3K/AKT signaling axis.Methods:The rat CIRI model was established using Longa's intraluminal suture method.The experimental design comprised four groups(n=15 per group):Sham operation group,CIRI model group,Scu treat-ment(40 mg/kg/d Scu gavage)group,and Scu+LY294002(Scu combined with PI3K inhibitor LY294002)group.Following 4 weeks of intervention,neurological function,pathological changes,and pathway protein expression were evaluated using Longa scoring,TTC staining,HE staining,transmission electron microscopy,immunofluorescence,or Western blot analysis.Results:Compared to the CIRI model group,Scu treatment significantly improved neurological function,reduced cerebral infarct volume and attenuated neuronal damage(P<0.05).Furthermore,Scu downregulat-ed CX3CL1/CX3CR1 expression,increased p-PI3K/PI3K and p-AKT/AKT ratios,elevated Bcl-2/Bax ratio,and de-creased IL-17A expression(P<0.05).These protective effects were partially reversed by LY294002.Conclusion:Scu exerts neuroprotective effects in cerebral CIRI injury by downregulating CX3CL1/CX3CR1 expression and activating the PI3K/AKT pathway,thereby attenuating inflammation and apoptosis.

Objective:To evaluate the reliability and validity of the Mandarin version of the patient-rated tennis elbow evaluation(PRTEE)for patients with tennis elbow.Method:With the permission of the author of the original questionnaire,the PRTEE was translated into Chi-nese following current international procedures.A total of 100 subjects were included in the study,and were assessed using the visual analogue scale(VAS),the Disabilities of the Arm,Shoulder,and Hand(DASH)ques-tionnaire,and PRTEE.A second assessment using the PRTEE was completed with 75 participants after one week.The internal consistency of the scale was evaluated using Cronbach's alpha coefficient,and the test-re-test reliability was evaluated using the intraclass correlation coefficient(ICC).The construct validity of the Mandarin version of PRTEE scale was examined by analyzing correlation with the Chinese version of VAS and DASH scores using Pearson's correlation coefficient.The ceiling or floor effect was determined by explor-atory analysis.Result:The Cronbach's alpha coefficient of PRTEE total score,pain and function subscales were 0.947,0.872,and 0.927,respectively.The ICC values for test-retest reliability of PRTEE total score,pain,and func-tion subscales were 0.988、0.975,and 0.980,respectively.The correlation coefficient between PRTEE total score and its two subscales and VAS ranged from 0.838 to 0.920(P＜0.01),indicating a strong correlation.The correlation coefficient between the PRTEE total score and two subscales,the DASH total score and two di-mensions ranged from 0.704 to 0.893(P＜0.01),indicating a strong correlation.There were no subjects who re-ceived the lowest or highest scores,indicating that the scale had no ceiling or floor effects.Conclusion:The Mandarin version of PRTEE demonstrates good reliability and validity,with no evidence of ceiling or floor effect.It is suitable for evaluating tennis elbow in Mandarin-speaking patients.

Objective:To investigate the neuroprotective efficacy of scutellarin(Scu)against cerebral ischemia-reperfusion(CIRI)injury in rats,with a focus on its regulatory mechanisms involving the CX3CL1/CX3CR1-PI3K/AKT signaling axis.Methods:The rat CIRI model was established using Longa's intraluminal suture method.The experimental design comprised four groups(n=15 per group):Sham operation group,CIRI model group,Scu treat-ment(40 mg/kg/d Scu gavage)group,and Scu+LY294002(Scu combined with PI3K inhibitor LY294002)group.Following 4 weeks of intervention,neurological function,pathological changes,and pathway protein expression were evaluated using Longa scoring,TTC staining,HE staining,transmission electron microscopy,immunofluorescence,or Western blot analysis.Results:Compared to the CIRI model group,Scu treatment significantly improved neurological function,reduced cerebral infarct volume and attenuated neuronal damage(P<0.05).Furthermore,Scu downregulat-ed CX3CL1/CX3CR1 expression,increased p-PI3K/PI3K and p-AKT/AKT ratios,elevated Bcl-2/Bax ratio,and de-creased IL-17A expression(P<0.05).These protective effects were partially reversed by LY294002.Conclusion:Scu exerts neuroprotective effects in cerebral CIRI injury by downregulating CX3CL1/CX3CR1 expression and activating the PI3K/AKT pathway,thereby attenuating inflammation and apoptosis.

Complex brain diseases seriously endanger human health, and early diagnostic biomarkers and effective treatments are currently lacking. Due to ethical constraints on human research, establishing monkey models is crucial to address these issues. With the rapid development of technology, transgenic monkey models of a range of brain diseases, especially autism spectrum disorder (ASD), have been successfully established. However, to establish practical and effective brain disease models and subsequently apply them to disease mechanism and treatment studies, there is still a lack of a standard tool, i.e., a system for collecting and analyzing the daily behaviors of brain disease model monkeys. Therefore, with the goal of undertaking a comprehensive and quantitative study of behavioral phenotypes, we established a standard daily behavior collection and analysis system, including behavioral data collection protocols and a monkey daily behavior ethogram (MDBE) for rhesus and cynomolgus monkeys, which are the most commonly used non-human primates in model construction. Then, we used ASD as an application example after referring to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), which is widely used in clinical disease diagnosis to obtain ASD core clinical symptoms. We then established a sub-ethogram (ASD monkey core behavior ethogram (MCBE-ASD)) specifically for quantitative assessment of the core clinical symptoms of an ASD monkey model based on MDBE. Subsequently, we demonstrated the high reproducibility of the system.
Animals ; Autism Spectrum Disorder ; Macaca mulatta ; Disease Models, Animal ; Behavior, Animal ; Macaca fascicularis ; Male ; Humans

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 search, evaluate, and summarize the best evidence for difficult peripheral intravenous catheterization in children.Methods:Following the "6S" evidence pyramid model, literature related to the management of difficult peripheral veins in children was searched in both English and Chinese databases including UpToDate, BMJ Best Practice, National Guidelines Clearinghouse, the Joanna Briggs Institute Evidence-Based Health Care Database, PubMed, Medlive, SinoMed, CNKI, and Wanfang Database. The search period was from the establishment of the database to January 2023. Two researchers trained in systematic evidence-based nursing, independently evaluated the quality of included literature and extracted relevant evidence.Results:Five articles were included: two guidelines, two expert consensuses, and one systematic review. 19 best evidence were summarized, covering five aspects: difficult vein quality management, difficult vein assessment, difficult intravenous catheterization site and needle type selection, difficult intravenous catheterization auxiliary methods, and handling of failed difficult intravenous catheterization.Conclusions:This study summarizes the best evidence for difficult peripheral intravenous catheterization in children, demonstrating clinical nursing practicality. It provides evidence-based guidance for pediatric nursing staff performing difficult intravenous catheterization.

Objective To explore the effect of case-based learning(CBL)combined with PICOS(population,interventions,compari-sons,outcomes,study design)framework in undergraduate occupational therapy(OT)education. Methods A total of 43 junior students majoring in OT from School of Rehabilitation Medicine,Nanjing Medical Univer-sity,were taught the core courses of OT using CBL combined with PICOS framework,from February,2023 to June,2024.The Evidence-based Practice Competency Assessment Scale was used to investigate the students at the beginning and the end of the semester,respectively. Results At the end of the semester,students'self-assessments improved in areas such as the quality evaluation of litera-ture,identifying the best scientific evidence,evaluating the quality of papers,conducting practical analysis of re-search,applying PICOS to formulate clinical questions,assessing the primary association measurement methods of research results,understanding different levels of evidence,and familiarity with commonly used evidence-based practice databases(χ2>4.778,P<0.05).Self-assessment regarding uncertainty about the decision-making process or the different recommendation strengths for health interventions(χ2=7.938,P<0.01)was lower.Atti-tudes toward evidence-based practice,skill levels,and knowledge all improved. Conclusion The combined application of CBL and PICOS framework could improve the effect of undergraduate OT ed-ucation and enhance the evidence-based practice ability of OT students.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2023.Methods Clinical isolates collected from 73 hospitals across China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2023 Clinical & Laboratory Standards Institute (CLSI) breakpoints.Results A total of 445199 clinical isolates were collected in 2023,of which 29.0％ were gram-positive and 71.0％ 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) (MRSA,MRSE and MRCNS) was 29.6％,81.9％ and 78.5％,respectively.Methicillin-resistant strains showed significantly higher resistance rates to most antimicrobial agents than methicillin-susceptible strains (MSSA,MSSE and MSCNS).Overall,92.9％ of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 91.4％ of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis had 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 93.1％ in the isolates from children and and 95.9％ in the isolates from adults.The resistance rate to carbapenems was lower than 15.0％ for most Enterobacterales species except for Klebsiella,22.5％ and 23.6％ of which were resistant to imipenem and meropenem,respectively .Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.6％ to 10.0％.The resistance rate to imipenem and meropenem was 21.9％ and 17.4％ for Pseudomonas aeruginosa,respectively,and 67.5％ and 68.1％ for Acinetobacter baumannii,respectively.Conclusions Increasing resistance to the commonly used antimicrobial agents is still observed in clinical bacterial isolates.However,the prevalence of important crabapenem-resistant organisms such as crabapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a slightly decreasing trend.This finding suggests that strengthening bacterial resistance surveillance and multidisciplinary linkage are important for preventing the occurrence and development of bacterial resistance.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2023.Methods Clinical isolates collected from 73 hospitals across China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2023 Clinical & Laboratory Standards Institute (CLSI) breakpoints.Results A total of 445199 clinical isolates were collected in 2023,of which 29.0％ were gram-positive and 71.0％ 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) (MRSA,MRSE and MRCNS) was 29.6％,81.9％ and 78.5％,respectively.Methicillin-resistant strains showed significantly higher resistance rates to most antimicrobial agents than methicillin-susceptible strains (MSSA,MSSE and MSCNS).Overall,92.9％ of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 91.4％ of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis had 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 93.1％ in the isolates from children and and 95.9％ in the isolates from adults.The resistance rate to carbapenems was lower than 15.0％ for most Enterobacterales species except for Klebsiella,22.5％ and 23.6％ of which were resistant to imipenem and meropenem,respectively .Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.6％ to 10.0％.The resistance rate to imipenem and meropenem was 21.9％ and 17.4％ for Pseudomonas aeruginosa,respectively,and 67.5％ and 68.1％ for Acinetobacter baumannii,respectively.Conclusions Increasing resistance to the commonly used antimicrobial agents is still observed in clinical bacterial isolates.However,the prevalence of important crabapenem-resistant organisms such as crabapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a slightly decreasing trend.This finding suggests that strengthening bacterial resistance surveillance and multidisciplinary linkage are important for preventing the occurrence and development of bacterial resistance.