Aim To investigate the mechanisms of Ke-chuanting granules(KCT)inhibiting the IL-33/ILC2s pathway and pathogenic T cells to intervene in allergic airway inflammation.Methods Network pharmacolo-gy was utilized to analyze the potential targets and mechanisms of KCT-treated asthma.Allergic asthma models were induced in mice using OVA.Lung histo-pathology was conducted to observe injury changes.ELISA and quantitative PCR were utilized to measure key inflammatory factors and their mRNA expression levels in Th2-type asthma.Western blot was used to detect the phosphorylation levels of relevant proteins in the MAPK pathway.Flow cytometry was performed to evaluate the proportions of ILC2s,Th1,Th 17,Th2 and Treg cells.Results Network pharmacology iden-tified 227 main active components and 143 key targets of KCT in treating asthma,primarily enriched in signa-ling pathways such as MAPK and IL-17.Further vali-dation experiments demonstrated that KCT significantly alleviated lung inflammatory injury in asthmatic mice,reduced the number of B cells,production of I L-4,TNF-α and TGF-β,downregulated JNK phosphoryla-tion levels in lung tissue,as well as mRNA levels of Il-33,Bcl11b,Rorα,Tcf-7,Jun,Mapk3 and Mapk14.KCT intervention reduced the numbers of ILC2s and Th 17 cells in lungs and spleens of mice,and inhibited Th2 cell infiltration in lungs.Conclusions KCT ex-hibits therapeutic effects on allergic airway inflamma-tion in asthma,closely associated with the inhibition of the IL-33/ILC2s pathway,pathogenic T cell subsets,and JNK-MAPK signaling pathway.

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 investigate the changing distribution and antibiotic resistance profiles of clinical isolates of Staphylococcus in hospitals across China from 2015 to 2021.Methods Antimicrobial susceptibility testing was conducted for the clinical isolates of Staphylococcus according to the unified protocol of CHINET(China Antimicrobial Surveillance Network)using disk diffusion method and commercial automated systems.The CHINET antimicrobial resistance surveillance data from 2015 to 2021 were interpreted according to the 2021 CLSI breakpoints and analyzed using WHONET 5.6.Results During the period from 2015 to 2021,a total of 204,771 nonduplicate strains of Staphylococcus were isolated,including 136,731(66.8％)strains of Staphylococcus aureus and 68,040(33.2％)strains of coagulase-negative Staphylococcus(CNS).The proportions of S.aureus isolates and CNS isolates did not show significant change.S.aureus strains were mainly isolated from respiratory specimens(38.9±5.1)％,wound,pus and secretions(33.6±4.2)％,and blood(11.9±1.5)％.The CNS strains were predominantly isolated from blood(73.6±4.2)％,cerebrospinal fluid(12.1±2.5)％,and pleural effusion and ascites(8.4±2.1)％.S.aureus strains were mainly isolated from the patients in ICU(17.0±7.3)％,outpatient and emergency(11.6±1.7)％,and department of surgery(11.2±0.9)％,whereas CNS strains were primarily isolated from the patients in ICU(32.2±9.7)％,outpatient and emergency(12.8±4.7)％,and department of internal medicine(11.2±1.9)％.The prevalence of methicillin-resistant strains was 32.9％in S.aureus(MRSA)and 74.1％in CNS(MRCNS).Over the 7-year period,the prevalence of MRSA decreased from 42.1％to 29.2％,and the prevalence of MRCNS decreased from 82.1％to 68.2％.MRSA showed higher resistance rates to all the antimicrobial agents tested except trimethoprim-sulfamethoxazole than methicillin-susceptible S.aureus(MSSA).Over the 7-year period,MRSA strains showed decreasing resistance rates to gentamicin,rifampicin,and levofloxacin,MRCNS showed decreasing resistance rates to gentamicin,erythromycin,rifampicin,and trimethoprim-sulfamethoxazole,but increasing resistance rate to levofloxacin.No vancomycin-resistant strains were detected.The prevalence of linezolid-resistant MRCNS increased from 0.2％to 2.3％over the 7-year period.Conclusions Staphylococcus remains the major pathogen among gram-positive bacteria.MRSA and MRCNS were still the principal antibiotic-resistant gram-positive bacteria.No S.aureus isolates were found resistant to vancomycin or linezolid,but linezolid-resistant strains have been detected in MRCNS isolates,which is an issue of concern.

Objective:To explore the effect of nursing intervention based on the integrated theory of health behavior change on the compliance of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) with continuous positive airway pressure (CPAP) treatment.Methods:From February 2023 to January 2024, convenience sampling was used to select 98 patients with moderate to severe OSAHS from the Sleep Center of Affiliated Wuxi Fifth Hospital of Jiangnan University as participants. Patients were divided into a control group and an experimental group based on their enrollment time, with 49 cases in each group. Control group received routine nursing, while experimental group was treated with nursing intervention based on the integrated theory of health behavior change. The compliance with CPAP was compared between two groups after three months of intervention, and the subjective daytime drowsiness, self-efficacy, social support, and quality of life were compared between the two groups before and after intervention.Results:After intervention, the compliance with CPAP in experimental group was higher than that in control group, and daytime sleepiness, self-efficacy, social support, and quality of life scores in experimental group were all better than those in control group, with statistical differences ( P<0.05) . Conclusions:Nursing intervention based on the integrated theory of health behavior change can increase compliance of OSAHS patients with CPAP, alleviate daytime sleepiness, enhance self-efficacy and social support, and improve quality of life.

Investigating the species/biovars,distribution patterns,and genetic correlations of Brucella from sheep in north-west China is critical to reveal the population and epidemiological characteristics of the Brucella melitensis.In this study,con-ventional identification and AMOS-PCR were used to determine the species/biovars of Brucella isolated from 13 regions in northwest China.MLST and MLVA-16 genotyping methods were used to analyze the genetic characteristics of the strains.Con-ventional identification and AMOS-PCR detection revealed that 59 Brucella melitensis were isolated in this study,in-cluding 22 strains from Inner Mongolia,17 strains from Xin-jiang,13 strains from Gansu,and 7 strains from Qinghai,of which 58 strains were B.melitensis biovar 3,and one strain was B.melitensis biovar 1.MLST analysis indicated that 90％(53/59)of B.melitensis were of ST8 sequence type,the dominant epidemic population.The MLVA-11 survey demonstrated that 59 B.melitensis strains clustered into six MLVA-11 genotypes,and 87％of the strains were of MLVA-11 genotype 116.Therefore,the predominant strains in the northwest region were from the Eastern Mediterranean lineage.MLVA-16 divided 59 strains of B.melitensis into 40 gen-otypes,eight of which were shared genotypes.Each genotype was composed of two to seven strains from the same region,thereby indicating that the cases of each shared genotype were outbreaks from a common source of infection.All shared MLVA-16 genotypes comprised strains from the same province,thus indicating apparent regional clustering characteristics of strains in each province.In a genetic comparison between populations and isolated strains from the spleens of sheep,multiple identical MLVA-16 genotypes were found to be composed of strains from different hosts.These findings indicated a transmission path-way from sheep/goats to humans.B.melitensis biovar 3 was the main pathogen causing animal brucellosis in the northwest re-gion,and infected sheep were the main brucellosis infection source in the regional population.The ST8 strains were the domi-nant epidemic population,and the MLVA genotype of strains in each region showed clear regional clustering characteristics.

Objective:To explore the plasma metabolomic characteristics of children with transfusion-dependent thalassemia(TDT),and reveal the changes of metabolic pattern in children with TDT.Methods:23 children with TDT who received regular blood transfusion in Ganzhou Women and Children's Health Care Hospital in 2021 were selected,and 11 healthy children who underwent physical examination during the same period were selected as the control group.The routine indexes between children with TDT and the control group were compared,and then the metabolic composition of plasma samples from children with TDT and the control group was detected by liquid chromatography-mass spectrometry.An OPLS-DA model was established to perform differential analysis on the detected metabolites,and the differential metabolic pathways between the two groups were analyzed based on the differential metabolites.Results:The results of routine testing showed that the indexes of ferritin,bilirubin,total bile acid,glucose and triglycerides in children with TDT were significantly higher than those in healthy controls,while hemoglobin and total cholesterol were significantly lower(all P＜0.05).However there was no significant difference in lactate dehydrogenase between the two groups(P＞0.05).Compared with the control group,190 differential metabolites(VIP＞1)were identified in TDT children.Among them,168 compounds such as arginine,proline and glycocholic acid were significantly increased,while the other 22 compounds such as myristic acid,eleostearic acid,palmitic acid and linoleic acid were significantly decreased.The metabolic pathway analysis showed that the metabolic impact of TDT on children mainly focused on the upregulation of amino acid metabolism and downregulation of lipid metabolism.Conclusion:The amino acid and lipid metabolism in children with TDT were significantly changed compared with the healthy control group.This finding is helpful to optimize the treatment choice for children with TDT,and provides a new idea for clinical treatment.

Objective:To investigate the expression level of urothelial carcinoembryonic antigen 1(lncRNA UCA1)in the bone marrow of acute myeloid leukemia(AML)patients,and to explore the clinical significance of lncRNA UCA1 expression level in AML patients.Methods:Bone marrow samples of 50 AML patients were collected as experimental group,and bone marrow samples of 20 iron deficiency anemia(IDA)patients were collected as control group.The relevant clinicopathological characteristics of AML patients were collected.Real-time quantitative PCR(qRT-PCR)was used to detect the expression level of lncRNA UCA1 in the experimental and control groups,and the relationships between lncRNA UCA1 expression and clinical pathological characteristics and prognosis in AML patients were analyzed.Kaplan-Meier curves were used to analyze the effect of lncRNA UCA1 on the overall survival(OS)of AML patients;And Cox regression model was used to analyze the factors affecting the prognosis of AML patients.Results:Compared with the control group,the expression level of lncRNA UCA1 was significantly elevated in patients with AML(P＜0.001);The proportion of patients with hemoglobin lower than 90 g/L in lncRNA UCA1 high expression group was significantly higher than that in lncRNA UCA1 low expression group(P=0.004);The expression level of lncRNA UCA1 was higher in M1,M2,and M4 subtypes,while it was lower in M0 and M5 subtypes,and the difference was statistically significant(P=0.009).There were no significant difference in sex,age,white blood cell(WBC)count,platelet(PLT)count,bone marrow blasts,chemotherapy regimen and efficacy,karyotype,gene mutation,and prognostic risk stratification between patients in UCA1 high expression group and those in UCA1 low expression group(all P＞0.05).The OS of patients with high expression of lncRNA UCA1 was significantly shorter than that of patients with low expression of lncRNA UCA1(P=0.0229).Conclusion:The expression level of lncRNA UCA1 is significantly upregulated in AML patients.High expression of lncRNA UCA1 is associated with poor clinicopathological features and poor prognosis.Therefore,lncRNA UCA1 can be used as a prognostic indicator and a potential therapeutic target for AML patients.

Objective:To evaluate the safety and efficiency of China-made Toumai Robot-assisted laparoscopic radical prosta-tectomy(LRP).Methods:This study included 40 cases of PCa treated from January 2023 to May 2023 by robot-assisted LRP with preservation of the bladder neck and maximal functional urethral length,15 cases with the assistance of Toumai Robot(the TMR group)and the other 25 with the assistance of da Vinci Robot as controls(the DVR group).We recorded the docking time,laparo-scopic surgery time,vesico-urethral anastomosis time,intraoperative blood loss and postoperative urinary continence,and compared them between the two groups.Results:Operations were successfully completed in all the cases.No statistically significant differ-ences were observed between the TMR and DVR groups in the docking time(6 min vs 5 min,P＞0.05)or intraoperative blood loss(200 ml vs 150 ml,P＞0.05).The TMR group,compared with the DVR group,showed a significantly longer median laparoscopic surgery time(146 min vs 130 min,P＜0.05)and median vesico-urethral anastomosis time(19 min vs 16 min,P＜0.05).There were no statistically significant differences between the TMR and DVR groups in the rates of urinary continence recovery immediately af-ter surgery(60.0％[9/15]vs 64.0％[16/25],P＞0.05)or at 1 month(80.0％[12/15])vs(76.0％[19/25],P＞0.05),3 months(93.3％[14/15])vs(92.0％[23/25],P＞0.05)and 6 months postoperatively(100％[15/15])vs(96％[24/25],P＞0.05).Conclusion:China-made Toumai? Robot surgical system is safe and reliable for laparoscopic radical prosta-tectomy,with satisfactory postoperative recovery of urinary continence.

Objective:To observe the intervention effect of aerobic Baduanjin exercise combined with treadmill train-ing on chronic obstructive pulmonary disease(COPD)complicated chronic heart failure(CHF).Methods:A total of 180 COPD+CHF patients who were treated in Mianyang Central Hospital from January 2019 to June 2021 were selected.They were equally divided into control group(basic treatment and intervention)and experimental group(received aerobic Baduanjin exercise combined with treadmill training based on control group)by random number table method,both groups were intervened for 12 weeks.COPD assessment test(CAT)score,left ventricular ejec-tion fraction(LVEF),left ventricular end systolic volume(LVESV),left ventricular end diastolic volume(LV-EDV),scores of modified medical research council(mMRC)and Minnesota living with heart failure questionnaire(MLHFQ)were compared between two groups before,4,8 and 12 weeks after intervention.Results:During 12-week intervention,CAT score,LVESV,LVEDV,scores of mMRC and MLHFQ showed a gradual decreasing trend,while LVEF showed a gradual increasing trend in two groups,P＜0.05 or＜0.01.Compared with control group after 12-week intervention,there were significant reductions in CAT score[(17.47±3.96)points vs.(13.36±3.42)points],LVEDV[(139.44±7.12)ml vs.(131.74±6.47)ml],LVESV[(81.84±8.54)ml vs.(74.29±9.18)ml],scores of mMRC[(1.67±0.47)points vs.(1.42±0.50)points],each dimension and total score of MLHFQ[(40.07±6.86)points vs.(32.54±6.61)points],and significant rise in LVEF[(41.29±4.76)％vs.(44.56±4.42)％]in experimental group(P＜0.001 all).Conclusion:Aerobic Baduanjin exercise combined with treadmill training based on basic treatment can significantly improve cardiopulmonary function,re-lieve dyspnea and improve quality of life in COPD+CHF patients,which is worth promoting.

Objective:To investigate the clinical features and influencing factors of prognosis in elderly patients with heart failure(HF)in ICU.Methods:Clinical data of 148 elderly HF patients(≥60 years old)admitted to ICU of our hospital from January to December 2021 were retrospectively analyzed.Disease history,etiology and related ex-amination data were analyzed in these patients,and predisposing factors and clinical features of HF were summa-rized.According to incidence of adverse cardiovascular events within 6 months,they were divided into event group(n=70)and no event group(n=78).General clinical data were compared between two groups.Univariate and multivariate Logistic regression were used to analyze influencing factors of poor prognosis in elderly HF patients in ICU.Results:Predisposing factors of elderly HF mainly included upper respiratory tract infections and pneumonia 34 cases(22.97％),20 cases(13.51％)of rapid atrial fibrillation and fatigue respectively.There were 91 cases(61.49％)with typical cardiac insufficiency as initial symptom;24 cases(16.22％)complicated with neuropsychiatric symptom;44 cases(29.73％)complicated with anxiety and depression of different extent.Univariate and multivariate Logistic regression a-nalysis indicated that age,NYHA class Ⅲ～Ⅳ,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score,N terminal pro brain natriuretic peptide(NT-proBNP),growth differentiation factor 15(GDF-15)and high sensitive C reactive protein(hsCRP)levels were independent risk factors for poor prognosis in elderly HF patients(OR=1.021～1.393,P＜0.05 or＜0.01).Conclusion:For elderly HF patients in ICU,clinical manifestations are not typical,and the predisposing factors are complex.It is found that APACHE Ⅱ score,GDF-15,hsCRP and NT-proBNP levels possess important significance for diagnosis and prognosis of these patients.