OBJECTIVE To observe the dynamic change trends of vancomycin resistance rates of Enterococcus fae-calis and Enterococcus faecium in medical institutions of Shanghai and nationwide based on the data from China Antimicrobial Resistance Surveillance System(CARSS)between 2014 and 2023 so as to provide bases for optimi-zing the prevention and control strategies for drug-resistant organisms.METHODS The data regarding to the van-comycin resistance rates of E.faecalis and E.faecium in Shanghai and nationwide were extracted from CARSS.The annual percentage change(APC),average annual percentage change(AAPC)and its 95％confi-dence interval(CI)were calculated by Joinpoint regression model(version 5.4.0).The differences in the changing trends and its statistical significance were analyzed.RESULTS The drug resistance rate of E.faecalis showed a re-markable and continuous decline in Shanghai(AAPC=-85.301％,P＜0.001),the isolation rate of the spe-cies maintained zero after 2019.The drug resistance rate nationwide showed a moderate decreasing amplitude(AAPC=-16.237％,P＜0.001),and there was no significant difference in the changing trend after 2019(P=0.628).The drug resistance rate of E.faecium showed a continuous decline trend in Shanghai(AAPC=-27.838％,P＜0.001),while the drug resistance rate nationwide firstly declined and then rose:with the decline from 2014 to 2020(APC=-18.476％,P＜0.001),the quick rebound from 2020 to 2023(APC=43.976％,P=0.005),and there was no significant difference in the overall change(AAPC=-1.459％,P=0.638).The decreasing amplitudes of drug resistance rates of the two species of Enterococcus were greater in Shanghai than nationwide(all P＜0.001),and the rebounds of drug resistance rates did not emerge nationwide.CONCLUSIONS Shanghai has achieved remarkable effect on control of drug resistance of Enterococcus through the management of antibiotics and infection control measures.The drug resistance rate of E.faecium re-bounds nationwide in recent years,indicating that the prevention and control should be strengthened in grass-roots medical institutions.It is suggested that Shanghai experience should be promoted,and the impact of transmis-sion mechanisms of drug resistance genes and COVID-19 epidemic on the use of antibiotics should be focused on.

Objective:To understand the characteristics of faculty in high-level public health schools in China, and analyze the differences in age, area and school level.Methods:Based on the internet information, the faculty information of 18 high-level public health schools was collected for a descriptive analysis on faculty characteristics.Results:There were 1 642 faculty members in the schools of public health in China, in whom 51.8% were women, 92.8% had doctorate, 32.4% had postdoctoral experience and 56.8% were former students staying to teach. The average age of the faculty members was (45.6±9.8) years. Meanwhile the top three study subjects were epidemiology and health statistics (31.0%), occupational health and environmental sanitation (16.5%), and health toxicology (16.3%). In the faculty members aged >40 years, 90.2% had doctorate, 62.6% were former students staying to teach, and 24.7% had no educational background of public health. The proportions of faculty members aged ≤40 years in the three groups mentioned above were 98.2%, 45.8% and 39.1% respectively. In terms of study subject, big data study were mainly conducted in the schools with top subject ranking and the schools in developed areas.Conclusions:The public health faculty was characterized by cross education background and high capability. The study subjects and sub-disciplines varied with schools and areas.

Objective To investigate the effects of circular RNA APLP2(circAPLP2)on the proliferation,migra-tion,and invasion of human colorectal cancer(CRC)cell lines by regulating microRNA-455-3p(miR-455-3p)/Stathmin1(STMN1)axis.Methods RT-qPCR was used to detect the expression of circAPLP2,miR-455-3p and STMN1 in CRC and normal colorectal cell lines and the optimal cell line was screened.Proliferation,migra-tion and invasion were detected by MTT assay,scratch assay and Transwell assay,respectively.The relationship between circAPLP2 and miR-455-3p,between miR-455-3p and STMN1 was confirmed by dual Lucifer's reporter gene assay.Results CircAPLP2 and STMN1 were highly expressed in CRC cells,miR-455-3p showed a low ex-pression.Knocking down circAPLP2 resulted in a decrease in rate of survival and of scratch healing rate and in-vasion of SW620 cells,An up regulation of miR-455-3p expression,a down regulation of STMN1,cyclin D1,N-cadherin protein expression and an up regulation of E-cadherin protein expression were also found(P<0.05).Inhibition of miR-455-3p expression reversed inhibitory effect of knocking down circAPLP2 on SW620 cell prolif-eration,migration,and invasion,up-regulated the STMN1,cyclin D1 and N-cadherin protein expression,and down-regulation of E-cadherin protein expression(P<0.05).Dual luciferase reporter gene assay showed that circAPLP2 targeted at negative regulation of miR-455-3p expression,while miR-455-3p targeted at negative reg-ulation of STMN1 expression.Nude mouse transplantation experiment found that knocking down circAPLP2 affect-ed the growth of transplanted tumors,while miR-455-3p expression was up-regulated and STMN1 expression was down-regulated(P<0.05).Conclusions CircAPLP2 inhibits the proliferation,migration and invasion of colorectal cancer cell lines by regulating the miR-455-3p/STMN1 axis.

Objective To explore the relationship between the duration of breastfeeding and re-fractive error in preschool children.Methods A cross-sectional survey was conducted to investigate the visual acuity of 2,915 preschool children aged 3 to 6 years using a questionnaire.Results After adjusting for potential confounding factors such as parental education level,premature birth,birth weight,family structure,only-child status,screen-watching,outdoor activity time,and sleep time u-sing a Logistic regression equation,compared with a breastfeeding duration of less than 6 months,a breastfeeding duration of 6 to 12 months(OR=0.683,95％CI:0.516 to 0.903)and＞12 months(OR=0.628,95％CI:0.451 to 0.874)were found to be protective factors against refractive error.Further stratified analysis revealed that a breastfeeding duration of 6 to 12 months(OR=0.640,95％CI:0.459 to 0.892)and＞12 months(OR=0.519,95％CI:0.347 to 0.777)had a protective effect on the visual acuity of preschool children aged 3 to 4 years.Conclusion The duration of breastfeed-ing is a protective factor against refractive error in preschool children aged 3 to 4 years,and prolonging the duration of breastfeeding is beneficial for reducing the occurrence of refractive error.

Objective:Interpret the key differences between the China Health-care Security Diagnosis Related Groups(CHS-DRG)2.0 and CHS-DRG 1.1,and provide reference for optimizing management strategies in medical institutions.Methods:Text analysis was used to import the CHS-DRG 2.0 and 1.1 grouping scheme dictionary data into the SQL database in a structured table format using SQL Server 2014.The key differences between the two schemes in grouping structure,grouping rules,grouping results,and other aspects were identified.Results:CHS-DRG 2.0 version added 26 groups,deleted 3 groups,and refined 10 groups into 20 groups for 14 clinical specialties at the ADRG level compared to CHS-DRG 1.1.Some group codes,names,and grouping rules were adjusted;Adjusted some grouping conditions and grouping results at the DRG level.Conclusion:CHS-DRG 2.0 version has improved grouping efficiency compared to CHS-DRG 1.1,solved some clinical bottleneck problems,and standardized the role of clinical diagnosis in grouping from the perspective of resource consumption.However,it has not completely solved the grouping problems of multi disease co treatment,multi disease treatment,and combined surgery.The adjustment of DRG weights and rates,the follow-up of related supporting policy reforms,and the negative effects of DRG will still pose challenges for medical institutions.

Objective:To analyze the clinical characteristics of acute leukemia complicated with arterial ischemic stroke (AIS) in children, and to provide a reference for its diagnosis, treatment, and prognosis.Methods:Case summary.This report presents three children with acute leukemia complicated with AIS admitted to the First Affiliated Hospital of Zhengzhou University from April 2015 to August 2024, and reviews the relevant literature at home and abroad to analyze the clinical characteristics, pathogenesis, and treatment of the disease.Results:All three cases were female, aged 4-14 years; two had acute lymphoblastic leukemia (ALL) and one had acute myeloid leukemia (AML). Hemiparesis was the main presenting symptom in all cases, occurring during induction therapy.Symptoms resolved completely after anticoagulant and symptomatic treatment, with no sequelae and good prognoses.A literature search identified 8 reported cases of pediatric acute leukemia complicated with AIS.Combining these with our 3 cases yielded a total of 11 cases: 5 males and 6 females; median age 7 years (range 2-15 years); 8 with ALL and 3 with AML.Clinically, all presented with hemiparesis.Vascular imaging in 6 patients showed involvement of the middle cerebral artery.In 8 cases of ALL complicated with AIS, the event occurred during induction therapy, which was considered associated with the use of Asparaginase and intrathecal Cytarabine.Anticoagulation was the main treatment.Symptoms resolved in 10 cases, 3 had neurologic sequelae, and 1 died.Conclusions:AIS complicating acute leukemia in children is often the first clinical manifestation of hemiparesis, which mainly occurs in the process of induction therapy, and may be related to the adverse reactions of chemotherapy drugs such as hypercoagulable state of the blood caused by mendonuclease and insufficient cerebral perfusion caused by intrathecal injection of Cytarabine, etc.; once hemiplegic neurological symptoms appear in the process of induction therapy of children′s acute leukemia, it is highly suspicious of the concomitant AIS, and earlycranial magnetic resonance examination can help to clarify the diagnosis.Although most symptoms resolve with treatment, some patients may develop neurological sequelae.

Objective:To understand the characteristics of faculty in high-level public health schools in China, and analyze the differences in age, area and school level.Methods:Based on the internet information, the faculty information of 18 high-level public health schools was collected for a descriptive analysis on faculty characteristics.Results:There were 1 642 faculty members in the schools of public health in China, in whom 51.8% were women, 92.8% had doctorate, 32.4% had postdoctoral experience and 56.8% were former students staying to teach. The average age of the faculty members was (45.6±9.8) years. Meanwhile the top three study subjects were epidemiology and health statistics (31.0%), occupational health and environmental sanitation (16.5%), and health toxicology (16.3%). In the faculty members aged >40 years, 90.2% had doctorate, 62.6% were former students staying to teach, and 24.7% had no educational background of public health. The proportions of faculty members aged ≤40 years in the three groups mentioned above were 98.2%, 45.8% and 39.1% respectively. In terms of study subject, big data study were mainly conducted in the schools with top subject ranking and the schools in developed areas.Conclusions:The public health faculty was characterized by cross education background and high capability. The study subjects and sub-disciplines varied with schools and areas.

Flow diverter (FD) devices have gradually become the mainstream approach for interventional treatment of intracranial aneurysms. In-stent stenosis (ISS) is a common complication after FD implantation, which can lead to ischemic events and affect the prognosis of patients. Current studies have shown that ISS occurrence is closely related to hemodynamic changes. From the perspective of hemodynamics, this article reviews the research progress of mechanisms, evaluation methods and treatments of ISS after FD implantation, in order to provide reference for clinical practice.

Objective:To investigate the safety and efficacy of Pipeline embolization device (PED) Shield in intracranial unruptured saccular aneurysms.Methods:This is a retrospective cohort study; 124 patients with intracranial unruptured saccular aneurysms treated with PED Shield at Department of Cerebrovascular Surgery, Neurosurgery Center, Zhujiang Hospital, Southern Medical University from July 2023 to October 2024 were enrolled. Intraoperative device-related complications and occurrence of hemorrhagic and ischemic complications within 30 days of the procedure were recorded. The clinical results and imaging results (degrees of stent patency and aneurysm occlusion rate) 6 months after follow-up were statistically analyzed. Modified Rankin scale (mRS) score>2 was defined as poor prognosis in clinical follow-up, and grade D according to O'Kelly Marotta (OKM) classification was considered as complete aneurysm occlusion in imaging follow-up.Results:Eighty-seven females and 37 males, aged (56.44±12.17) years (ranging from 27 to 80 years) were enrolled, with a maximum aneurysm diameter of 5.12 (3.73, 7.24) mm. Among the 124 patients, incidence of intraoperative instrument-related complications was 6.5% (8/124); and within 30 days of the procedure, incidence of ischemic complications was 4.8% (6/124) and that of hemorrhagic complications was 1.6% (2/124). Eighty-four patients had a 6-month clinical follow-up, with 1 patient (1.2%) having poor prognosis. Eighty-four patients (67.7%) completed a 6-month imaging follow-up: complete occlusion rate of aneurysms was 82.1% (69/84), incidence of in-stent stenosis (stenosis degree ≥25%) was 4.8% (4/84), and no symptomatic in-stent stenosis was found.Conclusion:Result of this study shows that PED Shield may be an effective and safe clinical option for intracranial unruptured saccular aneurysms.

Objective To analyze the risk factors for postoperative subdural effusion(SE)in patients with severe traumatic brain in-jury(sTBI)and create a column chart to predict the occurrence of postoperative SE in patients.Methods A retrospective analysis was conducted on the data of 223 patients with sTBI admitted to The People's Hospital of Danyang from March 2020 to December 2023.They were divided into SE group and non-SE group based on with or without postoperative SE.24 items of data collected from the SE group and non-SE group were compared,and multivariate Logistic regression were applied to analyze and screen for risk factors of postoperative SE occurrence.The determined predictive variables were introduced into R software to construct a column chart model,and the area under the receiver operator characteristic curve(ROC)curve(area under the curve,AUC)and correction curve were applied to test the predic-tive performance of the model.Results The incidence of postoperative SE in sTBI patients was 27.80％(62/223).There were statisti-cally obvious differences between the SE group and the non-SE group in terms of Glasgow coma scale(GCS)scores at admission,hema-toma volume,proportion of basilar cistern compression,proportion of subarachnoid hemorrhage(SAH),midline displacement distance,dehydrating agent application time ≥7days,and postoperative intracranial infection rate(P＜0.05).The risk factors for postoperative SE in patients with sTBI mainly included admission GCS score of 3-5 points,hematoma volume＞40ml,basal pool compression,SAH,midline displacement distance≥10mm,and application time of dehydrating agent ≥7days.Internal validation showed that the AUC was 0.840(95％CI:0.784-0.896),and the goodness of fit Hosmer-Lemeshow test showed x2=6.860,P=0.552,with better curve fit-ting.Conclusion A column chart based on GCS score at admission,hematoma volume,whether the basal pool,whether SAH,midline displacement distance and time of dehydrating agent application has a good predictive effect on postoperative SE occurrence in sTBI patients.