Objective To investigate the distribution and antimicrobial resistance profiles of clinical isolates in Xi'an No.3 Hospital from 2019 to 2023.Methods Clinical isolates were collected from January 1,2019 to December 31,2023.Antimicrobial susceptibility testing was carried out according to a unified protocol of China Antimicrobial Resistance Surveillance Network using Kirby-Bauer method or automated systems.The data were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2023.Results A total of 6 621 clinical isolates were collected from 2019 to 2023,including 1 569(23.7％)strains of Gram-positive bacteria and 5 052(76.3％)strains of Gram-negative bacteria.The prevalence of methicillin-resistant S.aureus,S.epidermidis and other Staphylococcus species(except SS.pseudintermedius and S.schleiferi)was 39.0％,62.3％,and 74.4％,respectively.Methicillin-resistant strains showed much higher resistance rates to most of other antimicrobial agents than methicillin-sensitive strains.No Staphylococcus strains were found resistant to vancomycin or linezolid.E.faecium strains demonstrated much higher resistance rates to most antimicrobial agents tested than E.faecalis.The prevalence of linezolid-resistant E.faecalis and vancomycin-resistant E.faecium was 0.9％and 0.4％,respectively.The prevalence of penicillin-nonsusceptible strains(PISP+PRSP)was 5.8％in nonmeningitis S.pneumoniae isolates.The prevalence of ESBL-producing E.coli,K.pneumoniae,and P.mirabilis in Enterobacterales was 48.5％,37.8％,and 47.2％,respectively.Among Enterobacterales strains,K.pneumoniae had the highest resistance rate to imipenem(18.2％)and meropenem(17.9％).Other Enterobacterales were highly sensitive to carbapenems.The resistance rates of P.aeruginosa to imipenem and meropenem were 22.5％and 19.5％,respectively.The resistance rates of A.baumannii to imipenem and meropenem were 65.0％and 71.6％,respectively.Conclusions Antibiotic resistance is still serious in this hospital.Nearly half of the strains of E.coli,K.pneumoniae and P.mirabilis produced ESBLs.K.pneumoniae and A.baumannii showed high resistance rates to carbapenems.Antimicrobial resistance surveillance should be performed appropriately.Relevant departments need to strengthen cooperation to curb the spread of drug-resistant bacteria.

Objective To investigate the distribution and antimicrobial resistance profiles of clinical isolates in Xi'an No.3 Hospital from 2019 to 2023.Methods Clinical isolates were collected from January 1,2019 to December 31,2023.Antimicrobial susceptibility testing was carried out according to a unified protocol of China Antimicrobial Resistance Surveillance Network using Kirby-Bauer method or automated systems.The data were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2023.Results A total of 6 621 clinical isolates were collected from 2019 to 2023,including 1 569(23.7％)strains of Gram-positive bacteria and 5 052(76.3％)strains of Gram-negative bacteria.The prevalence of methicillin-resistant S.aureus,S.epidermidis and other Staphylococcus species(except SS.pseudintermedius and S.schleiferi)was 39.0％,62.3％,and 74.4％,respectively.Methicillin-resistant strains showed much higher resistance rates to most of other antimicrobial agents than methicillin-sensitive strains.No Staphylococcus strains were found resistant to vancomycin or linezolid.E.faecium strains demonstrated much higher resistance rates to most antimicrobial agents tested than E.faecalis.The prevalence of linezolid-resistant E.faecalis and vancomycin-resistant E.faecium was 0.9％and 0.4％,respectively.The prevalence of penicillin-nonsusceptible strains(PISP+PRSP)was 5.8％in nonmeningitis S.pneumoniae isolates.The prevalence of ESBL-producing E.coli,K.pneumoniae,and P.mirabilis in Enterobacterales was 48.5％,37.8％,and 47.2％,respectively.Among Enterobacterales strains,K.pneumoniae had the highest resistance rate to imipenem(18.2％)and meropenem(17.9％).Other Enterobacterales were highly sensitive to carbapenems.The resistance rates of P.aeruginosa to imipenem and meropenem were 22.5％and 19.5％,respectively.The resistance rates of A.baumannii to imipenem and meropenem were 65.0％and 71.6％,respectively.Conclusions Antibiotic resistance is still serious in this hospital.Nearly half of the strains of E.coli,K.pneumoniae and P.mirabilis produced ESBLs.K.pneumoniae and A.baumannii showed high resistance rates to carbapenems.Antimicrobial resistance surveillance should be performed appropriately.Relevant departments need to strengthen cooperation to curb the spread of drug-resistant bacteria.

Objective: To learn the temporal and spatial distribution of abnormalalanine aminotransferase（ALT）and its influencing factorsamong candidates for the high school entrance examination in Beijing,and to provide evidence for prevention of abnormal ALT in adolescents. Methods: The physical examination data of the candidates in Beijing from 2009 to 2018 were collected from Beijing Physical Examination Center. The time,space and population distribution of abnormal ALT was analyzed;the time-space interaction trend of abnormal ALT was described by bubble map;and the Bayesian spatio-temporal model was built to explore the influencing factors of abnormal ALT in middle school students. Results: Among 884 915 candidates,5 354 candidates had abnormal ALT,accounting for 0.61%. The rate of abnormal ALT showed an upward trend from 2009 to 2018（P<0.05）.The rate of abnormal ALT was 0.95% in males and 0.23% in females,5.09% in obese candidates and 0.18% in non-obese ones,0.70% in urban area and 0.48% in rural area,and the differences between gender,obesity and residence were all statistically significant（P<0.05）. From 2009 to 2018,the rates of abnormal ALT among the candidates in Changping District remained the highest;the rate in Shunyi District and Daxing District showed an increasing trend;the rates in Haidian District,Chaoyang District and Fengtai District were relatively high,the rates in Miyun District and Pinggu District were relatively low,while the trend of them were not obvious. The results of the Bayesian space-time model showed that the risk of abnormal ALT increased by 5.706 times for each unit increase of regional male percentage and increased by 8.679 times for each unit increase of regional obesity percentage. Conclusion The rate of abnormal ALT among candidates for the high school entrance examination in Beijing shows a upward trend. The rates of abnormal ALT among the candidates in Changping District,Haidian District,Chaoyang District and Fengtai District are relatively high,and the rates in Shunyi District and Daxing District tend to rise. Males and obese students are the high risk groups of abnormal ALT.

Authors of the paper analyzed the motivation of building the healthy town,and interrelated the scientific aspects of such a town. It was found that this town of diversified resources and advantages had become small but beautiful,special and strong clustering and convergent by means of collecting high-end factors, selecting of essential health businesses and constructing an ecosystem of health industry clusters. Based on a definition of the government role,the paper described the innovation of health policy in view of policy supply.

Described in the paper is the reform made at public hospitals in Zhejiang province,with analysis of its problems and causes. Based on such,the authors proposed the following actions:to accelerate the reform of public hospitals centering on health promotion, and encourage such hospitals to shoulder the health care responsibility on behalf of the government; to proceed with hierarchical medical system and contract-based service focusing on capacity building of general practitioners; to attract private capital into building the healthcare system; and to motivate non-governmental organizations to cater to diversified healthcare needs of the people.

Objective To study and observe the effect of transnasal endoscopic surgery in the treatment of patients with fungal paranasal sinusitis.Methods A total of 82 cases of patients with fungal paranasal sinusitis were collected and divided into the control group (40 cases) and the observation group (40 cases) according to the principles of random,single blind and parallel control design,the patients in the control group received conventional surgical treatment,and the patients in the observation group received transnasal endoscopic surgical treatment,the two groups were observed and compared in terms of treatment efficiency,sinus cavity scores in the lesion range,average operation time,postoperative complication rate and patients' satisfaction degree.Results The effective rate in treatment group was 94.6％,significantly higher than that of control group (80.0％);the lesions sinus cavity score was 0 points in observation group,significantly lower than the control group (13.1 ± 1.9),the average operation time was (45.4 ± 10.9) min in the observation group,significantly shorter in the control group (76.3 ± 10.5) min;the postoperative complication rate was 3.2％ in the observation group,which was significantly lower than that of 25.6％ in the control group (P＜0.05).Conclusion The transnasal endoscopic surgery in the treatment of patients with fungal paranasal sinusitis can effectively improve the treatment efficiency,remove the mold lesions in the sinuses of patients,shorten the operation time and reduce the postoperative complication rate,and is conducive to promoting the rehabilitation of patients and improving the quality of life of patients,thus it is worth popularization and application.

In the teaching reform of anatomy,department of human anatomy in Heze medical college put forward a new teaching means-Non-verbal communication teaching.The reasonable use of the paralanguage,gesture,posture,eye contact,facial expressions can optimize the teaching of anatomy and achieve good teaching effect.