Objective:To analyze the genomic characteristics and antibiotic resistance of Listeria monocytogenes isolated from food sources in Beijing City in 2022. Methods:A total of 83 strains of Listeria monocytogenes were isolated from three major categories of food, namely raw poultry, raw livestock meat and ready-to-eat foods, in Beijing′s food safety risk monitoring in 2022. Whole-genome sequencing (WGS) was performed to determine serogroups, multilocus sequence typing (ST) and core genome multilocus sequence typing (cgMLST). Virulence genes and antibiotic resistance genes were identified using the VFDB and ResFinder 3.0 databases. Antimicrobial susceptibility to eight antibiotics was tested via the broth microdilution method. Results:The predominant serogroup was 1/2a, 3a (61.2%). All the isolates were divided into 14 STs, with ST121 (21.7%), ST8 (20.5%), ST9 (13.3%), and ST87 (13.3%) as the dominant types. All 83 isolates were classified into 75 cgMLST types, with six clusters showing identical profiles, indicating potential clonal transmission. Comparative genomic analysis revealed that strains of the same ST clustered together regardless of geographic origin, and some Beijing isolates differed by fewer than 10 alleles from strains isolated in other countries. All the isolates in the study carried virulence islands 1(LIPI-1) and LIPI-2. LIPI-3 was detected in ST1, ST11 and ST3 isolates, while LIPI-4 was found in ST87 isolates. About 42 isolates (50.6%, including ST1, ST11, ST5, ST307, ST8, ST9, ST155, and ST3) harbored SSI-1, and 18 ST121 isolates carried SSI-2. Only 3.61% (three strains) and 4.82% (four strains) of isolates exhibited resistance to tetracycline and erythromycin, respectively. No resistance to other tested antibiotics was observed.Conclusion:Foodborne Listeria monocytogenes in Beijing exhibits high genomic diversity but is dominated by specific STs, some of which are associated with hypervirulence. Some Beijing isolates have homology with food-derived isolates from other countries.

Objective:To systematically evaluate the incidence and risk factors of acute kidney injury (AKI) induced by vancomycin in pediatric patients.Methods:Databases of PubMed, Embase, The Cochrane Library, Web of Science, CNKI, Wanfang, VIP, Chinese Biomedical Database (CBM) were searched and articles about the risk factors of AKI induced by vancomycin in pediatric patients from inception to June 2024 were collected. Quality assessment was performed using the Newcastle-Ottawa Scale (NOS) for the included studies. Meta-analysis of the data for relevant exposure factors extracted from the included literature was conducted using Rev Man 5.4. The strength of association between the exposure factors and AKI was expressed using the odds ratio ( OR) and its 95% confidence interval ( CI). Results:A total of 13 studies were entered, involving 11 073 patients. Of them, 1 388 patients were in AKI group and 9 685 patients in non-AKI group. The incidence of AKI was 12.53%, ranging from 4.62% to 27.07%. The quality evaluation results showed that the 13 documents were all of high-quality (NOS score ≥7 points). Meta-analysis showed that admission to intensive care unit (ICU) ( OR=2.39, 95% CI: 1.59-3.59, P<0.001), vancomycin using time ≥7 d ( OR=2.19, 95% CI: 1.44-3.34 P=0.003), vancomycin steady-state trough concentration ≥15 mg/L ( OR=2.98, 95% CI: 2.22-4.01, P<0.001), combined with nephrotoxic drugs ≥2 kinds ( OR=2.92, 95% CI=1.84-4.64, P<0.001), combined with piperacillin sodium and tazobactam sodium ( OR=2.71, 95% CI: 1.72- 4.27, P<0.001), combined with carbapenem ( OR=2.36, 95% CI: 1.36-4.10, P=0.002), combined with aminoglycosides ( OR=1.78, 95% CI: 1.35-2.35, P<0.001), combined with loop diuretics ( OR=3.16, 95% CI: 2.36- 4.23, P<0.001), combined with amphotericin B ( OR=2.26, 95% CI: 1.35-3.79, P=0.002), combined with contrast medium ( OR=2.34, 95% CI: 1.04-5.25, P=0.040), and combined with aciclovir ( OR=1.74, 95% CI: 1.04-2.84, P=0.030) were all risk factors of AKI induced by vancomycin in pediatric patients. Conclusions:The incidence of vancomycin-related AKI in pediatric patients was 12.53%. Admission to ICU, vancomycin trough concentration ≥15 mg/L, medication time ≥7 d, and concomitant use of ≥2 nephrotoxic drugs and etc.were risk factors of vancomycin-related AKI.

Objective:To analyze the genomic characteristics and antibiotic resistance of Listeria monocytogenes isolated from food sources in Beijing City in 2022. Methods:A total of 83 strains of Listeria monocytogenes were isolated from three major categories of food, namely raw poultry, raw livestock meat and ready-to-eat foods, in Beijing′s food safety risk monitoring in 2022. Whole-genome sequencing (WGS) was performed to determine serogroups, multilocus sequence typing (ST) and core genome multilocus sequence typing (cgMLST). Virulence genes and antibiotic resistance genes were identified using the VFDB and ResFinder 3.0 databases. Antimicrobial susceptibility to eight antibiotics was tested via the broth microdilution method. Results:The predominant serogroup was 1/2a, 3a (61.2%). All the isolates were divided into 14 STs, with ST121 (21.7%), ST8 (20.5%), ST9 (13.3%), and ST87 (13.3%) as the dominant types. All 83 isolates were classified into 75 cgMLST types, with six clusters showing identical profiles, indicating potential clonal transmission. Comparative genomic analysis revealed that strains of the same ST clustered together regardless of geographic origin, and some Beijing isolates differed by fewer than 10 alleles from strains isolated in other countries. All the isolates in the study carried virulence islands 1(LIPI-1) and LIPI-2. LIPI-3 was detected in ST1, ST11 and ST3 isolates, while LIPI-4 was found in ST87 isolates. About 42 isolates (50.6%, including ST1, ST11, ST5, ST307, ST8, ST9, ST155, and ST3) harbored SSI-1, and 18 ST121 isolates carried SSI-2. Only 3.61% (three strains) and 4.82% (four strains) of isolates exhibited resistance to tetracycline and erythromycin, respectively. No resistance to other tested antibiotics was observed.Conclusion:Foodborne Listeria monocytogenes in Beijing exhibits high genomic diversity but is dominated by specific STs, some of which are associated with hypervirulence. Some Beijing isolates have homology with food-derived isolates from other countries.

Objective:To systematically evaluate the incidence and risk factors of acute kidney injury (AKI) induced by vancomycin in pediatric patients.Methods:Databases of PubMed, Embase, The Cochrane Library, Web of Science, CNKI, Wanfang, VIP, Chinese Biomedical Database (CBM) were searched and articles about the risk factors of AKI induced by vancomycin in pediatric patients from inception to June 2024 were collected. Quality assessment was performed using the Newcastle-Ottawa Scale (NOS) for the included studies. Meta-analysis of the data for relevant exposure factors extracted from the included literature was conducted using Rev Man 5.4. The strength of association between the exposure factors and AKI was expressed using the odds ratio ( OR) and its 95% confidence interval ( CI). Results:A total of 13 studies were entered, involving 11 073 patients. Of them, 1 388 patients were in AKI group and 9 685 patients in non-AKI group. The incidence of AKI was 12.53%, ranging from 4.62% to 27.07%. The quality evaluation results showed that the 13 documents were all of high-quality (NOS score ≥7 points). Meta-analysis showed that admission to intensive care unit (ICU) ( OR=2.39, 95% CI: 1.59-3.59, P<0.001), vancomycin using time ≥7 d ( OR=2.19, 95% CI: 1.44-3.34 P=0.003), vancomycin steady-state trough concentration ≥15 mg/L ( OR=2.98, 95% CI: 2.22-4.01, P<0.001), combined with nephrotoxic drugs ≥2 kinds ( OR=2.92, 95% CI=1.84-4.64, P<0.001), combined with piperacillin sodium and tazobactam sodium ( OR=2.71, 95% CI: 1.72- 4.27, P<0.001), combined with carbapenem ( OR=2.36, 95% CI: 1.36-4.10, P=0.002), combined with aminoglycosides ( OR=1.78, 95% CI: 1.35-2.35, P<0.001), combined with loop diuretics ( OR=3.16, 95% CI: 2.36- 4.23, P<0.001), combined with amphotericin B ( OR=2.26, 95% CI: 1.35-3.79, P=0.002), combined with contrast medium ( OR=2.34, 95% CI: 1.04-5.25, P=0.040), and combined with aciclovir ( OR=1.74, 95% CI: 1.04-2.84, P=0.030) were all risk factors of AKI induced by vancomycin in pediatric patients. Conclusions:The incidence of vancomycin-related AKI in pediatric patients was 12.53%. Admission to ICU, vancomycin trough concentration ≥15 mg/L, medication time ≥7 d, and concomitant use of ≥2 nephrotoxic drugs and etc.were risk factors of vancomycin-related AKI.

Objective To develop a evidence-based and local decision supporting tool for breast reconstruction for breast cancer surgery based on Ottawa decision support framework to guide clinical decision-making and promote the implementation of shared decision-making.Methods Based on Ottawa decision support framework and International Patient Decision Aid Standards 4.0(IPDAS4.0),the initial version of breast reconstructive surgery decision support tool was proposed through a literature review.Eighteen clinical and nursing experts specialised in breast cancer and breast reconstruction were invited to participate in 2 rounds of Delphi consultations and resulted in a revised version of the tool.Following a pilot test involving 5 patients and 5 family members in clinical settings,their feedback was integrated into the revised version to create a final version of the tool.Results The initial version of the tool were developed based on the literature review and evidence synthesis,comprising 7 primary indicators,14 secondary indicators and 49 tertiary indicators.In the first round of consultation on the 3-tier indicators,the average importance scores ranged from 4.06 to 4.94,with coefficients of variation were 0.05-0.22,and proportions of full marks ranged from 0.53 to 0.88.In the second round of consultation on the 3-tier indicators,the average importance scores ranged from 4.71 to 4.94,with coefficients of variation were 0.05-0.15,and proportions of full marks ranged from 0.72 to 1.00.Kendall's W coefficients for the primary,secondary and tertiary indicators in the second round were 0.509,0.437,and 0.425,respectively.The finalised decision support tool for breast cancer and breast reconstruction included 7 primary indicators covering decision evaluation,disease information support,risk and benefit analysis,decision support system,balance value and preference,promotion of decision making,evaluation of decision quality,alongside 14 secondary indicators and 50 tertiary indicators.Clinical trials confirmed the finalised effectiveness of the tool.Conclusion The decision support tool for breast cancer and breast reconstruction which developed on the basis of Ottawa decision support framework demonstrates scientific rigor and clinical value.It provides solutions for breast cancer patients when facing difficulties in making a decision for breast reconstruction surgery.

Objective:Farfarae Flos has the effect of cough suppression and phlegm elimination,with cough suppression as the main function.Studies have revealed that certain components of Farfarae Flos may be related to its cough suppressant effect,and some components have been confirmed to have cough suppressant activity.However,the antitussive material basis of Farfarae Flos has not been systematically elucidated.This study aims to elucidate the group of active ingredients in Farfarae Flos with cough suppressant activity by correlating the high performance liquid chromatography(HPLC)fingerprint of Farfarae Flos extract with its cough suppressant activity. Methods:HPLC was used to establish the fingerprint profiles of 10 batches of Farfarae Flos extract and obtain their chemical composition data.Guinea pigs were selected as experimental animals and the citric acid-induced cough model was used to evaluate the antitussive efficacy data of 10 batches of Farfarae Flos extract.SPF-grade healthy male Hartley guinea pigs were randomly divided into the S1 to S10 groups,a positive control group,and a blank control group(12 groups in total),with 10 guinea pigs in each group.The S1 to S10 groups were respectively administered Farfarae Flos extract S1 to S10(4 g/kg),the positive control group was administered pentoverine citrate(10 mg/kg),and the blank control group was administered purified water.Each group received continuous oral administration for 5 days.The guinea pigs were placed in 5 L closed wide-mouth bottles,and 17.5%citric acid was sprayed into the bottle with an ultrasonic atomizer at the maximum spray intensity for 0.5 minutes.The cough latency period and cough frequency in 5 minutes were recorded for each guinea pig.Grey relational analysis(GRA)and partial least squares regression(PLSR)were used to conduct spectral-effect correlation analysis of the chemical composition data of Farfarae Flos extract and the antitussive efficacy data,and predict the group of active ingredients in Farfarae Flos with antitussive activity.The bioequivalence verification was conducted to verify the predicted group of active ingredients in Farfarae Flos with antitussive activity:SPF-grade healthy male Hartley guinea pigs were randomly divided into a S9 group,an active ingredient group,a positive control group,and a blank control group(4 groups in total),with 10 guinea pigs in each group.The S9 group was administered Farfarae Flos extract S9(4 g/kg),the active ingredient group was administered the predicted combination of antitussive active ingredients(dose equivalent to 4 g/kg of Farfarae Flos extract S9),the positive control group was administered pentoverine citrate(10 mg/kg),and the blank control group was administered purified water.Each group received continuous oral administration for 5 days,and animal modeling and observation of efficacy indicators were the same as above. Results:The HPLC fingerprint of 10 batches of Farfarae Flos extract was established,and the peak area data of 14 main common peaks were obtained.The antitussive effect data of 10 batches of Farfarae Flos extract were obtained.Compared with the blank control group,the cough latence in the positive control group and S1,S2,S3,S4,S6,S7,S8,S9,S10 groups was prolonged(all P<0.01),while the cough frequency in 5 minutes in the positive control group and S1,S2,S4,S6,S8,S9,S10 groups was decreased(all P<0.05).The analysis of spectrum-effect relationship revealed that isochlorogenic acid C,isochlorogenic acid A,chlorogenic acid,isochlorogenic acid B,isoquercitrin,and rutin had high contribution to the antitussive effect of Farfarae Flos,and the 6 components were predicted to be the antitussive component group of Farfarae Flos.The verification of bioequivalence showed that there were no statistically significant differences in the antitussive effect between the S9 group and the antitussive component composition group(all P>0.05),which confirmed that isochlorogenic acid C,isochlorogenic acid A,chlorogenic acid,isochlorogenic acid B,isoquercetin,and rutin were the antitussive component group of Farfarae Flos. Conclusion:The analysis of spectrum-effect relationship combined with the verification of bioequivalence could be used to study the antitussive material basis of Farfarae Flos.The antitussive effect of Farfarae Flos is the result of the joint action of many components.

Objective:To construct Doctor-Nurse-Patient shared decision-making framwork for breast cancer surgery patients, so as to provide a foundation for clinical practice.Methods:The content of the shared decision-making framwork were initially constructed through systematic literature search and group discussion. From March to May 2021, 24 experts were consulted by the Delphi method, and the weight of each element would be determined by the analytic hierarchy process.Results:A total of 2 rounds of expert letter questionnaires were implemented. The authority coefficient of the experts in this study was 0.832, the Kendall coefficient of the experts in the first round was 0.130-0.261 ( P<0.01), and the Kendall coefficient of the experts in the second round was 0.130-0.272 ( P<0.01). The final shared decision-making framwork includes 5 first-level indicators, 15 second-level indicators and 52 third-level indicators. Conclusions:The Doctor-Nurse-Patient shared decision-making framwork of breast cancer surgery patients constructed in this study is scientific and practical, and provides a reference for clinical practice of shared decision-making in the future.

Objective:To investigate the effect of cyclin D1 (CCND1) negatively regulated by miRNA-541 (miR-541-5p) on the proliferation and migration of colon cancer cells as well as its related mechanism.Methods:Expression levels of miR-541-5p in colon cancer cell lines HT29, SW480, SW620, HCT116 and enterocyte line HIEC of the normal people as well as cancer tissues and pericarcinomatous normal tissues of 112 patients undergoing the colon cancer surgery from the First Affiliated Hospital of Hebei North University between April 2017 and March 2020 were detected by using quantitative real-time polymerase chain reaction(qRT-PCR). The potential target gene of miR-541-5p was predicted by using TargetScan, and was verified by using dual luciferase reporter gene assay, qRT-PCR and Western blot. Expression level of CCND1 was detected in colon cancer cell lines and tissues. Cells with the lowest expression level of miR-541-5p were divided into miR-NC group (the transfected control plasmid), miR-541-5p group (the transfected miR-541-5p mimics), miR-541-5p+CCND1 group (the co-transfected miR-541-5p mimics and CCND1). Effect of miR-541-5p and CCND1 on proliferation and migration ability of colon cancer cells was detected by using cell counting kit-8 (CCK8) and Transwell method. The xenograft model of colon cancer in nude mice was constructed to observe the effect of miR-541-5p on tumor growth.Results:The relative expression level of miR-541-5p in colon cancer tissues was lower than that in pericarcinomatous normal tissues (0.45±0.06 vs. 1.00±0.12, t = 43.385, P < 0.01). The relative expression level of miR-541-5p was 0.46±0.03, 0.67±0.04, 0.57±0.06, 0.17±0.02, 1.00±0.15, respectively in colon cancer cell lines HT29, SW480, SW620, HCT116 and enterocyte line HIEC of the normal people, and the difference was statistiacally significant ( F = 5.621, P < 0.01); the relative expression level of miR-541-5p in all colon cancer cell lines was lower than that in enterocyte line HIEC of the normal people. HCT116 cells were selected to make the subsequent experiments. The predicted results of TargetScan showed that 3'UTR of CCND1 might have sites complementary to those of miR-541-5p. Dual luciferase reporter gene assay showed that CCND1 was the target gene of miR-541-5p, and miR-541-5p negatively regulated the expression of CCND1. CCK-8 method showed that cell proliferation rate of HCT116 was (2.00±0.16)%, (0.89±0.08)%, (2.56±0.23)%, respectively in miR-NC group, miR-541-5p group, miR-541-5p+CCND1 group, and the difference was statistically significant ( F = 6.715, P < 0.01); among HCT116 cells with the overexpression of miR-541-5p, the transfected CCND1 chould reverse the inhibitory effect of miR-541-5p on cell proliferation. Transwell results showed that the overexpression of miR-541-5p inhibited the cell migration ability of HCT116, while the co-transfection of miR-541-5p mimics and CCND1 could reverse the inhibitory effect. In the colon cancer nude mice xenograft model, the tumor mass and size of nude mice in miR-541-5p group was decreased compared with that in the control group (all P < 0.05). Conclusions:miR-541-5p inhibits cell proliferation and migration of colon cancer cells via negatively regulating CCND1, and inhibits tumor growth in xenograft model of colon cancer in nude mice, thereby acting as a tumor suppressor in colon cancer.

Objective To compare the regulating effect of electrically stimulating different parts of the auri-cle on the cardiac vagus nerve in rats, and to explore the basic neural mechanism. Methods The tragus, concha auriculae and helix of 24 male Sprague-Dawley rats were stimulated at different intensities ( 0-16 mA) and with differ-ent durations ( 0-15 min) and any changes in the heart rate were observed. One week later, the rats were randomized into a tragus injection group, a concha auriculae injection group, a helix injection group and a control group, each of 6. The rats of the first three groups were injected with 2 μL of cholera toxin subunit B conjugate AF555 ( CTB-AF555) at the right auricle, while the control group was injected with the same amount of aseptic phosphate-buffered saline at the right tragus. Five days later, all of the rats were sacrificed and their right superior and inferior ganglia and the whole bulbus medullae were resected to observe the fluorescent labeling sites. Results The rats'heart rate declined with longer and more intense stimulation of the tragus or concha auriculae, but not with stimulation of the he-lix. With stimulation of the same duration, a significant decrease was observed in the heart rate when the tragus and concha auriculae were stimulated at 10, 12, 14 or 16 mA compared with when the helix was stimulated at the same intensities. The heart rate when the concha auriculae was stimulated at 12 mA was significantly slower than when the tragus was stimulated at the same intensity. At identical stimulus intensities, the heart rate slowed significantly more when the tragus was stimulated for 6 to 15 minutes and the concha auriculae for 4 to 15 minutes compared with stimu-lating the helix for the same length of time. And compared with stimulating the tragus for 6 to 10 minutes, the heart rate decreased significantly more when the concha auriculae was stimulated for the same length of time. All of the rats in the tragus and concha auriculae injection groups displayed nerve tracer in their superior and inferior ganglia. In the tragus injection group, CTB-AF555 was observed in the nucleus tractus solitarius ( NTS) of 3 of the 6 rats. In the concha auriculae injection group it was observed in 4 of the 6. In the helix injection group, CTB-AF555 was observed in the nucleus of the spinal tract in 5 of the 6 rats, but no nerve tracer was found in their superior or inferior ganglia or in the NTS. Conclusion Electrical stimulation of the tragus and concha auriculae can regulate the functioning of the cardiac vagus nerve, but stimulating the helix cannot. This is partly because the nerve signals in tragus or concha auriculae stimulation and the cardiac sensory nerve signal are integrated in the inferior ganglion and then analyzed and processed in the bulbar center to monitor the heart.

Objective To establish clinical pharmacists' competency behavior questionnaire and confirm the validity of the competency model of clinical pharmacists. Methods On the basis of previous model research, clinical pharmacists' behavior questionnaire combining the Likert scaling and literature retrieval method was established,and the competency model was verified by method of exploring factor analysis and " construct validity" and confirmatory factor analysis. Results Questionnaire included 47 characteristic projects and ten basic information projects.Exploratory factor analysis extracted 5 factors,whose content was in accordance with the model of competency characteristics.Cronbach 's alpha coefficients of each factor project were (0.510-0.961).Discrimination validity of the behavior questionnaire was good.T-test results showed good statistical difference between the outstanding group and the normal group, and the empirical validity of the model was better. Confirmatory factor analysis of structural equation model was acceptable,and the CIF was 0. 825. Conclusion The competency model is valid and can distinguish clinical pharmacists with excellent performance.