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.

Osteoarthritis is a chronic inflammatory disease characterized by non inflammatory degeneration of articular cartilage and the formation of osteophytes at the edge of the joint, caused by complex causes. Its pathology is complex, and its pathogenesis is not yet clear, ultimately leading to joint stiffness and functional activity disorders. At present, the treatment for osteoarthritis is limited to alleviating symptoms and improving function, with varying degrees of side effects. Ferroptosis is a new type of programmed cell death discovered in recent years, which is related to the pathological and physiological processes of osteoarthritis and plays an important regulatory role in the occurrence and development of osteoarthritis. Its main characteristics include iron metabolism imbalance and accumulation of reactive oxygen species. Therefore, ferroptosis inhibitors targeting ferroptosis have shown great application prospects in the treatment of osteoarthritis. In this review, the author summarizes the relevant mechanisms of ferroptosis in the occurrence and development of osteoarthritis, outlines a large number of specific therapeutic drugs and their corresponding targets, with the aim of delaying and reversing the progression of osteoarthritis by regulating chondrocyte ferroptosis, which has certain clinical guiding significance.

Pancreatic cancer is a more aggressive and refractory malignancy. Resistance and toxicity limit drug efficacy. Herein, we report a lower toxic and higher effective miriplatin (MPt)-loaded liposome, LMPt, exhibiting totally different anti-cancer mechanism from previously reported platinum agents. Both in gemcitabine (GEM)-resistant/sensitive (GEM-R/S) pancreatic cancer cells, LMPt exhibits prominent anti-cancer activity, led by faster cellular entry-induced larger accumulation of MPt. The level of caveolin-1 (Cav-1) determines entry rate and switch of entry pathways of LMPt, indicating a novel role of Cav-1 in nanoparticle entry. After endosome-lysosome processing, in unchanged metabolite, MPt is released and targets mitochondria to enhance binding of mitochondria protease LONP1 with POLG and TFAM, to degrade POLG and TFAM. Then, via PINK1-Parkin axis, mitophagy is induced by POLG and TFAM degradation-initiated mitochondrial DNA (mtDNA) replication blocking. Additionally, POLG and TFAM are identified as novel prognostic markers of pancreatic cancer, and mtDNA replication-induced mitophagy blocking mediates their pro-cancer activity. Our findings reveal that the target of this liposomal platinum agent is mitochondria but not DNA (target of most platinum agents), and totally distinct mechanism of MPt and other formulations of MPt. Self-assembly offers LMPt special efficacy and mechanisms. Prominent action and characteristic mechanism make LMPt a promising cancer candidate.

Objective To investigate the status quo of health literacy,motivation and self-management behaviours of patients with knee osteoarthritis(KOA),to explore the influence of health literacy and motivation on self-management behaviours to the patients with KOA,and to clarify the relationships among the three factors.Methods Convenience sampling method was used to select 169 KOA patients who were treated in 3 tertiary hospitals in Xianyang between September and December 2021.General status table,chronic disease health literacy scale,patient motivation scale and chronic disease self-management behaviour scale were employed in the on-the-spot survey.Pearson correlation was used to analyze the correlation of health literacy,motivation and self-management behaviour of patients with KOA.Results Total scores of health literacy,motivation and self-management behaviour of the patients with KOA were 79.66±11.91,54.97±9.95 and 23.75±8.89,respectively.It was found that health literacy and motivation of the patients were positively correlated with their self-management behaviour(r=0.872,r=0.822,both P<0.01).Health literacy of the patients was positively correlated with motivation of patients(r=0.877,P<0.01).Health literacy of the patients could be used to directly predict self-management behaviour of patients(β=0.708,95%CI:0.539-0.876),as well as to predict self-management behaviour of the patients through the mediating effect of patient motivation(β=0.228,95%CI:0.676-0.787).The mediating effect accounted for 24.36%of the total effect.Conclusions The health literacy,motivation and self-management behaviours of patients with KOA are all poor and they should be further improved.Patient motivation is the mediating variable in health literacy and self-management behaviour of the patients.It is suggested that nursing staff could encourage the motivation of patients hence to improve the self-management behaviour in the patients with KOA based on an improvement of health literacy.

Objective:To investigate the status quo of professional identity of nursing undergraduates in Beijing and analyze its influencing factors and to provide basis for carrying out professional identity education of nursing undergraduates.Methods:Using the convenient sampling method, a total of 726 nursing undergraduates from four undergraduate colleges in Beijing from June to September 2020 were selected as research objects. General information questionnaire, Professional Identity Questionnaire for Nurse Students (PIQNS) and Professional Self-efficacy Questionnaire for Nurse Students (PSQNS) were used to investigate them. A total of 726 questionnaires were distributed and 615 valid questionnaires were recovered.Results:The total scores of PIQNS and PSQNS among 615 nursing undergraduates in Beijing were respectively 55.00 (36.00, 66.00) and 86.00 (60.00, 101.00) . There was a positive correlation between PIQNS total score and PSQNS total score of nursing undergraduates ( r=0.928, P<0.01) . The results of multiple linear regression analysis showed that gender, whether there was a class tenure, whether he was an only child, reasons for attending nursing major and whether he had clinical practice or internship experience were the influencing factors of professional identity of nursing undergraduates in Beijing ( P<0.01) , which could explain 17.6% of the total variation. Conclusions:The professional identity of nursing undergraduates in Beijing is at the medium level and still needs to be improved. Nursing educators should pay attention to the emotional and psychological status of nursing undergraduates and take appropriate measures to provide vocational education for nursing undergraduates, so as to further improve their professional identity.

Objective:To evaluate the effect of interstitial lung disease(ILD) on postoperative morbidity and mortality in pulmonary resection for lung cancer patients.Methods:We retrospectively analyzed 971 patients undergoing pulmonary operation from January 2010 to January 2018 in our hospital. Clinical data including age, sex, history of chronic obstructive pulmonary disease(COPD), smoking history, smoking index, American Society of Anesthesiologists(ASA) classification, forced expiratory volume in 1 s(FEV1) % predict, surgical procedure, video assisted thoracoscopic surgery(VATS) or not, intraoperative blood transfusion, anesthesia time, operation time/one-lung ventilation time, blood loss, histology, postoperative morbidity, 60-days mortality, onset of acute exacerbation of interstitial lung disease(AE-ILD), drainage, extubation time, and postoperative stay were collected and analyzed.Results:There were 80(8.2%) and 891(91.8%) patients in ILD and non-ILD group, respectively. AE-ILD occurred in 5 patients, with a 60-day mortality of 80%. A multivariate regression analysis identified that the sex( P=0.023), ILD( P=0.001), COPD( P=0.027) were independent risk factors for postoperative morbidity. ILD( P=0.023) and postoperative morbidity( P=0.001) were independent risk factors for 60-day mortality in multivariate analysis. Conclusion:Patients with ILD had a higher incidence of postoperative morbidity and 60-day mortality. Based on the obvious postoperative morbidity and mortality, special attention and management should be taken in ILD patients.

Objective To study the superiority of severe multiple trauma treatment model based on damage control strategy. Methods In the intergrated injury first-aid mode, the intensive care unit-guided damage control strategy was used to treat severe multiple trauma. Results A total of 789 severe multiple damage patients were treated with damage control strategies in our hospital from December 2018 to December 2018. Sixty-nine patients died and the survival rate was 91.25％. Conclusions The intensive care unit-guided trauma control strategy has a satisfactory clinical effect in the treatment of patients with severe multiple trauma.

Objective     To investigate the significance of neoadjuvant chemotherapy in the treatment of limited-disease small cell lung cancer (LD-SCLC). Methods     We retrospectively analyzed the clinical data of 55 LD-SCLC patients who underwent surgery in the Department of Thoracic Surgery, China-Japan Friendship Hospital from May 2007 to August 2016. There were 42 males and 13 females with a mean age of 57 years. All patients underwent clinical staging before treatment. According to the different treatments, the patients were divided into two groups, a preoperative neoadjuvant chemotherapy group and a direct surgery group. The comparison of long-term survival rates was made between the two groups. Results     Among the 55 patients, median survival time was 27 months. The 1-, 3-, 5-year survival rate was 89.1%, 45.0%, 33.8% respectively. Treatment methods and clinical N stage were significantly different in prognosis (P<0. 05). The results of Cox proportional hazards regression model showed that clinical N stage was prognostic factor of LD-SCLC patients (P<0. 05). Conclusion     Patients with clinical stage Ⅰ and Ⅱ SCLC are better to receive direct surgery. For patients with clinical stage Ⅲ, it is recommended to reach partial response or complete response with neoadjuvant chemotherapy before surgery. The status of lymph node metastasis is closely related to survival, thus identifying the accurate clinical stage is crucial before treatment.

Small cell lung cancer is a pathological type with higher malignancy in lung cancer, and has biological characteristics different from non-small cell lung cancer, such as rapid growth, high malignancy and poor prognosis. Mediastinal lymph node and distant metastasis occur frequently. In recent years, the treatment of limited-stage small cell lung cancer has been stagnant, and various treatments are poor. The operation is mainly suitable for patients with small cell lung cancer (T1-2N0M0). Small cell lung cancer has strong sensitivity to chemotherapy, but the clinical application of neoadjuvant chemotherapy in T1-2N0M0 small cell lung cancer remains controversial. This article reviewed the value of neoadjuvant chemotherapy in the treatment of T1-2N0M0 small cell lung cancer.

Objective To investigate the clinical significance of tumor related gene gankyrin expression in pancreatic cancer.Methods The immunohistochemical staining was performed to study the gankyrin expression in 62 pairs of pancreatic cancer and matched non-tumor tissues.The correlations ofgankyrin expression with pathological parameters and the influences on the prognosis were analyzed.Results Ggankyrin positivity in pancreatic cancer and matched non tumor tissue was 2.5％ (45/62)and 19.4％ (12/62),respectively.The positivity of gankyrin was significantly higher in pancreatic cancer compared with matched non-tumor tissues,and the differences were statistical significant (P ＜ 0.01).Gankyrin expression in pancreatic cancer tissues were significantly correlated with TNM stage,differentiation and metastasis (P ＜ 0.05),but not with age,gender or tumor location (P ＞ 0.05).The 3-year survival rates of patients with positive and negative gankyrin expression were 17.8 ％ (8/45)and 41.2％ (7/17),respectively.Patients with positive gankyrin expression had a significantly shorter survival period compared with these with negative expression in pancreatic cancer tissues (P =0.034).Conclusions Gankyrin was overexpressed in pancreatic cancer,which was correlated with poor prognosis.