Objective To investigate the distribution and antibiotic resistance profiles of clinical isolates in Beijing Children's Hospital,Capital Medical University from 2016 to 2022.Methods All the strains isolated from inpatients in Beijing Children's Hospital during the period from 2016 to 2022 were analyzed.Antimicrobial susceptibility test was conducted by Kirby-Bauer method or automated system.Results were interpreted according to the breakpoints recommended in the CLSI Ml00 2022 edition.Results A total of 24 904 isolates were analyzed,including Gram-positive bacteria(49.4％)and Gram-negative bacteria(50.6％).The top three Gram-positive bacteria were Staphylococcus aureus(15.6％),coagulase-negative Staphylococcus(14.0％),and Streptococcus pneumoniae(8.9％).The top three Gram-negative bacteria were Klebsiella spp.(8.6％),Pseudomonas aeruginosa(8.6％),and Haemophilus influenzae(8.1％).The prevalence of methicillin-resistant strains was 30.9％in SS.aureus(MRSA)and 82.7％in coagulase-negative Staphylococcus(MRCNS).The prevalence of PRSP was 75.0％(24/32)in meningitis isolates and 2.6％(57/2 195)in non-meningitis isolates.Five strains of E.faecium and 10 strains of E.faecalis were found resistant to linezolid.Two strains of E.faecium were resistant to vancomycin.The prevalence of extended-spectrum beta-lactamases(ESBLs)and carbapenem-resistant strains(CREco)in E.coli isolates was 69.0％and 9.7％,respectively.The prevalence of ESBLs and carbapenem-resistant strains(CRKpn)in K.pneumoniae isolates was 73.7％,and 37.2％,respectively.The prevalence of carbapenem-resistant strains was 21.9％in P.aeruginosa isolates and 59.3％in A.baumannii isolates.β-lactamase was detected in 68.3％of the H.influenzae isolates.Conclusions Antimicrobial resistance is still serious in children.It is necessary to strength the surveillance of bacterial resistance and use antibiotics rationally in order to curb the spread of drug-resistant strains.

Objective To explore the value of artificial intelligence-assisted compressed sensing(ACS)-MR cine imaging(Cine)for assessing biventricular function and left ventricular myocardial strain compared with conventional cardiac Cine and united compressed sensing(uCS)-Cine.Methods A total of 30 subjects who underwent conventional Cine,uCS-Cine and ACS-Cine were prospectively enrolled.Based on a 5-point scale,subjective scoring of image quality was performed and compared among 3 sequences.Biventricular function parameters and myocardial strain parameters of the left ventricle,including left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF),left ventricular end-diastolic mass(LVEDM),right ventricular end-diastolic volume(RVEDV),right ventricular end-systolic volume(RVESV),right ventricular ejection fraction(RVEF),left ventricular global radial strain(LVGRS),left ventricular global circumferential strain(LVGCS)and left ventricular global longitudinal strain(LVGLS)were measured and compared among sequences.Results The subjective image quality scores of all 3 sequences were≥3,of ACS-Cine and conventional Cine were not significantly different(adjusted P=0.306)but both slightly higher than that of uCS-Cine(both adjusted P＜0.05).LVEDV,LVEF and LVEDM based on ACS-Cine and uCS-Cine were not significantly different(all adjusted P＞0.05),but all lower than those of conventional Cine(all adjusted P＜0.05).No significant difference of LVESV was found between each two sequences(all adjusted P＞0.05).RVEDV based on ACS-Cine was lower than that based on conventional Cine,RVESV based on ACS-Cine was higher than that based on uCS-Cine,and RVEF based on ACS-Cine was lower than that based on uCS-Cine and conventional Cine(all adjusted P＜0.05),while no significant difference of right ventricular functional parameters was observed between uCS-Cine and conventional Cine(all adjusted P＞0.05).Both ACS-Cine and uCS-Cine had lower LVGRS and LVGCS than conventional Cine(all adjusted P＜0.05),with no significant difference was found between uCS-Cine and ACS-Cine(both adjusted P＞0.05).No significant difference of LVGLS was observed among 3 sequences(P＞0.05).Conclusion ACS-Cine could be used as appropriate supplement to conventional Cine for clinical assessment of biventricular function and left ventricular myocardial strain.

Objective To investigate the distribution and antibiotic resistance profiles of clinical isolates in Beijing Children's Hospital,Capital Medical University from 2016 to 2022.Methods All the strains isolated from inpatients in Beijing Children's Hospital during the period from 2016 to 2022 were analyzed.Antimicrobial susceptibility test was conducted by Kirby-Bauer method or automated system.Results were interpreted according to the breakpoints recommended in the CLSI Ml00 2022 edition.Results A total of 24 904 isolates were analyzed,including Gram-positive bacteria(49.4％)and Gram-negative bacteria(50.6％).The top three Gram-positive bacteria were Staphylococcus aureus(15.6％),coagulase-negative Staphylococcus(14.0％),and Streptococcus pneumoniae(8.9％).The top three Gram-negative bacteria were Klebsiella spp.(8.6％),Pseudomonas aeruginosa(8.6％),and Haemophilus influenzae(8.1％).The prevalence of methicillin-resistant strains was 30.9％in SS.aureus(MRSA)and 82.7％in coagulase-negative Staphylococcus(MRCNS).The prevalence of PRSP was 75.0％(24/32)in meningitis isolates and 2.6％(57/2 195)in non-meningitis isolates.Five strains of E.faecium and 10 strains of E.faecalis were found resistant to linezolid.Two strains of E.faecium were resistant to vancomycin.The prevalence of extended-spectrum beta-lactamases(ESBLs)and carbapenem-resistant strains(CREco)in E.coli isolates was 69.0％and 9.7％,respectively.The prevalence of ESBLs and carbapenem-resistant strains(CRKpn)in K.pneumoniae isolates was 73.7％,and 37.2％,respectively.The prevalence of carbapenem-resistant strains was 21.9％in P.aeruginosa isolates and 59.3％in A.baumannii isolates.β-lactamase was detected in 68.3％of the H.influenzae isolates.Conclusions Antimicrobial resistance is still serious in children.It is necessary to strength the surveillance of bacterial resistance and use antibiotics rationally in order to curb the spread of drug-resistant strains.

Objective To explore the value of artificial intelligence-assisted compressed sensing(ACS)-MR cine imaging(Cine)for assessing biventricular function and left ventricular myocardial strain compared with conventional cardiac Cine and united compressed sensing(uCS)-Cine.Methods A total of 30 subjects who underwent conventional Cine,uCS-Cine and ACS-Cine were prospectively enrolled.Based on a 5-point scale,subjective scoring of image quality was performed and compared among 3 sequences.Biventricular function parameters and myocardial strain parameters of the left ventricle,including left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF),left ventricular end-diastolic mass(LVEDM),right ventricular end-diastolic volume(RVEDV),right ventricular end-systolic volume(RVESV),right ventricular ejection fraction(RVEF),left ventricular global radial strain(LVGRS),left ventricular global circumferential strain(LVGCS)and left ventricular global longitudinal strain(LVGLS)were measured and compared among sequences.Results The subjective image quality scores of all 3 sequences were≥3,of ACS-Cine and conventional Cine were not significantly different(adjusted P=0.306)but both slightly higher than that of uCS-Cine(both adjusted P＜0.05).LVEDV,LVEF and LVEDM based on ACS-Cine and uCS-Cine were not significantly different(all adjusted P＞0.05),but all lower than those of conventional Cine(all adjusted P＜0.05).No significant difference of LVESV was found between each two sequences(all adjusted P＞0.05).RVEDV based on ACS-Cine was lower than that based on conventional Cine,RVESV based on ACS-Cine was higher than that based on uCS-Cine,and RVEF based on ACS-Cine was lower than that based on uCS-Cine and conventional Cine(all adjusted P＜0.05),while no significant difference of right ventricular functional parameters was observed between uCS-Cine and conventional Cine(all adjusted P＞0.05).Both ACS-Cine and uCS-Cine had lower LVGRS and LVGCS than conventional Cine(all adjusted P＜0.05),with no significant difference was found between uCS-Cine and ACS-Cine(both adjusted P＞0.05).No significant difference of LVGLS was observed among 3 sequences(P＞0.05).Conclusion ACS-Cine could be used as appropriate supplement to conventional Cine for clinical assessment of biventricular function and left ventricular myocardial strain.

Objective:To analyze and explore the independent risk factors of 28-day mortality in patients with septic myocardial injury.Methods:A retrospective cohort study was conducted to collect clinical data of 505 patients diagnosed with sepsis related myocardial injury admitted to the intensive care unit (ICU) of the Affiliated Hospital of Jining Medical University from January 2015 to December 2020. According to the 28-day survival status of patients, they were divided into survival group and death group. COX multivariate regression analysis was used to analyze the influencing factors of the 28-day mortality rate of sepsis related myocardial injury patients, and receiver operating characteristic (ROC) curves were drawn to evaluate the effectiveness of independent risk factors in predicting the 28-day mortality rate of sepsis related myocardial injury patients.Results:A total of 505 patients with sepsis myocardial injury were included, of which 282 survived on 28 days and 223 died, with a mortality rate of 44.16%. COX multivariate regression analysis showed that Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score, blood lactate (LAC), oxygenation index (PaO 2/FiO 2), admission heart rate, and albumin were independent risk factors for sepsis associated myocardial injury mortality at 28 days (all P<0.05). ROC curve analysis showed that the area under the ROC curve (AUC) of SOFA score was 0.766 2, and the 95% confidence interval (95% CI) was 0.724 5-0.807 9; The predictive value of 28-day mortality in sepsis associated myocardial injury patients was superior to APACHE Ⅱ score, LAC, PaO 2/FiO 2, admission heart rate, and albumin [The AUC values were 0.754 1(0.711 5-0.796 7), 0.752 6(0.710 1-0.795 1), 0.697 0(0.649 7-0.744 2), 0.623 2(0.573 7-0.672 7), and 0.620 3(0.570 8-0.669 7), respectively]. Conclusions:SOFA score, APACHE Ⅱ score, LAC, PaO 2/FiO 2, admission heart rate, and albumin are independent risk factors for the 28-day mortality rate of sepsis related myocardial injury. Clinical practice should identify these factors early, intervene early, and improve patient prognosis.

Objective:To investigate the effect of Astragaloside Ⅳ on high glucose-induced cardiomyocyte pyroptosis.Methods:H9c2 cells were cultured in vitro and divided into control group(5.5 mmol/L glucose), high glucose group(33.3 mmol/L glucose), Astragaloside Ⅳ group(33.3 mmol/L glucose+ 100μmol/L Astragaloside Ⅳ), and NLRP3 inhibitor group(33.3 mmol/L glucose+ 1μmol/L MCC950). Cell counting kit 8(CCK-8)was used to detect the activity of H9c2 cells.Lactate dehydrogenase(LDH)kit was used to detect the content of LDH in cell supernatant.Superoxide anion fluorescent probe(DHE)was used to detect the level of intracellular reactive oxygen species(ROS). Real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)and Western blot were used to detect the mRNA and protein expression levels of pyroptosis-related genes.Immunofluorescence was used to detect the fluorescence intensity of NLRP3.Enzyme-linked immunosorbent assay(ELISA)was used to detect the level of inflammatory factors in cell supernatant.Results:When the concentration of Astragaloside Ⅳ was 100 μmol/L, it could significantly inhibit the decrease of cardiomyocyte viability induced by high glucose( P<0.01)and reduce LDH release( P<0.01). Compared with the control group, the level of ROS was increased( P<0.01), the mRNA and protein expressions of pyroptosis-related molecules were up-regulated( P<0.01 for all), the fluorescence intensity of NLRP3 was increased( P<0.01), and the levels of inflammatory factors in the cell supernatant were increased in the high glucose group( P<0.01). Compared with the high glucose group, the ROS level was decreased( P<0.01), the mRNA and protein expressions of pyroptosis-related molecules were down-regulated( P<0.05 or P<0.01), the fluorescence intensity of NLRP3 was decreased( P<0.01), and the levels of inflammatory factors in cell supernatant were decreased( P<0.05 or P<0.01)in Astragaloside Ⅳ group and inhibitor group. Conclusions:Astragaloside Ⅳ plays a protective role in high glucose-induced cardiomyocyte injury by inhibiting NLRP3/Caspase-1 signaling pathway and inhibiting pyroptosis.Moreover, it can improve the anti-inflammatory and antioxidant properties in cell models.

Objective:To develop a list of basic and expanded medical laboratory tests in community health service centers in Shanghai.Methods:The status quo of human and equipment resource allocation, the test items and quality control currently performed, the perspectives of various stakeholders, the capacity building of community clinical laboratory in community health service centers in Shanghai were investigated by quantitative survey and qualitative interview; and the rating scores of each test item were assessed by expert consultation using Delphi method. The expert focus discussion was conducted, and each test item was rated and classified. Finally a list of the basic tests and expanded tests in clinical laboratories of community health service center was developed.Results:A total of 247 questionnaires were distributed and 192 (77.7%) were answered. A list of 94 laboratory test items was screened out based on the questionnaire survey of the laboratories of the community health centers. Thirty one experts in the relevant areas were invited to rate the test items, the average authority coefficient of experts was 0.90, with which the weighted average of the expert ratings was made. There were 45 (47.9%) items scored 7 or higher, 38 (40.4%) scored between 5 and 7, and 11 (11.7%) scored less than 5. Based on the results of the expert focus discussion, 48 items were recommended as the basic tests and 46 items as the extended tests.Conclusion:In this study a list of tests recommended to clinical laboratories in Shanghai community health service centers has been developed, which contains 48 basic tests and 46 extended tests.

Objective:To investigate the protective effects and related mechanisms of Astragaloside Ⅳ(ASⅣ)alleviating Angiotensin II-induced cardiomyocyte hypertrophy.Methods:H9c2 cardiomyocytes were divided into six groups: normal control group, ASⅣ group(ASⅣ 100 μmol/L), AngⅡ group(AngⅡ 1 μmol/L), and three ASⅣ dose experiments(AngⅡ 1 μmol/L + ASⅣ 25 μmol/l group, AngⅡ 1 μmol/L+ ASⅣ 50 μmol/l group, AngⅡ1 μmol/L+ ASⅣ 100 μmol/L group), and simultaneously cultured for 24 hours.Cardiomyocyte viability was assessed by CCK8 assay, and surface area of culturedcardiomyocytes in each group was assessed by immunofluorescence assay.Atrial natriuretic peptide(ANP)mRNA expression was assessed by fluorescence real-time quantitative RT-PCR.And LC3 protein expression, an autophagy related protein, was assessed by Western blotting as well as immunofluorescence.Results:(1)AngⅡ decreased cardiomyocyte H9c2 viability in a dose-dependent manner( P<0.05). ASⅣ could inhibit the decrease of cardiomyocyte H9c2 viability in response to AngⅡ in a dose-dependent manner( P<0.05). (2)H9c2 cardiomyocytes induced by AngⅡ showed a significantly larger cell area and significantly higher ANP mRNA and ANP protein expression compared with controls.Different concentrations of ASⅣ intervention could reverse the increase of cardiomyocyte H9c2 area induced by AngⅡ and also decreased the expression of ANP protein induced by AngⅡ in a dose-dependent manner(all P<0.05). (3)Compared with the control group, the autophagy level and the expression of autophagy marker LC3II/I of H9c2 cardiomyocytes induced by AngⅡ were significantly increased(all P<0.05). ASⅣ could inhibit AngⅡ-activated autophagy, and the difference was statistically significant( P<0.05). ASⅣ inhibited the expression of LC3II/I in H9c2 cardiomyocytes stimulated by AngⅡ, and the difference was statistically significant( P<0.05). Conclusions:ASⅣ inhibits AngⅡ-induced cardiac hypertrophy by inhibiting autophagy of cardiomyocytes.

Stress cardiomyopathy (SCM) is a kind of clinical syndrome characterized by transient ventricular enlargement and left ventricular regional systolic dysfunction caused by strong mental stimulation or physical stress, and accompanied by electrocardiogram (ECG) changes. Its clinical symptoms and ECG manifestations are similar to those of acute coronary syndrome in the early stage of onset, which is easy to be misdiagnosed. However, patients in intensive care unit (ICU) are often in critical and severe condition, and they often preceded different degrees by emotional or physical stress. Therefore, patients in ICU are prone to complicated with SCM. Otherwise, the symptoms of SCM patients in ICU are not typical. Early diagnosis and optimal treatment are the key to improve the prognosis of patients in ICU. The etiology, epidemiology, pathophysiological mechanism, diagnosis and management of SCM in ICU are reviewed in this paper.