AIM:To investigate the associations of triglyceride glucose(TyG)index, triglyceride glucose-body mass index(TyG-BMI), and homeostatic model assessment of insulin resistance(HOMA-IR)with diabetic retinopathy(DR), and to evaluate their diagnostic value.METHODS: This study was a single-center retrospective study. Patients with type 2 diabetes mellitus(T2DM)who were hospitalized in the endocrinology department of 3201 Hospital from January 1, 2023 to March 1, 2025 were included. According to the diagnostic criteria for DR, participants were classified into DR group and non-DR(NDR)group. Then the association of TyG index, TyG-BMI, and HOMA-IR index with DR of the two groups of patients were alalyzed.RESULTS:A total of 969 patients with T2DM were enrolled in this study, including 816 patients in the DR group. Among DR group, 271 were males(33.2%)and 545 were females(66.8%), with a mean age of 56.78±11.88 years. The NDR group consisted of 153 patients, including 41 males(26.8%)and 112 females(73.2%), with a mean age of 59.40±10.52 years. Statistically significant differences were observed between the DR group and the NDR group in terms of age, BMI, TyG index, TyG-BMI, HOMA-IR index, fasting blood glucose(FBG), 2-h postprandial blood glucose(2 hPBG), fasting insulin(FINS), 2-h postprandial insulin(2 hPINS), fasting C-peptide(FCP), 2-h postprandial C-peptide(2 hPCP), total cholesterol(CHO), triglyceride(TG), low-density lipoprotein(LDL-C), blood urea nitrogen(BUN), uric acid(UA), direct bilirubin(DBIL), glycated hemoglobin(HbA1c), milligrams per total protein(M-TP), microalbuminuria(MALB), urinary albumin to creatinine ratio(UACR), 24-hour urine protein, white blood cell(WBC), neutrophil(N), and platelets(PLT; all P<0.05), while no significant differences were found in the remaining indicators(all P>0.05). In multivariable Logistic regression, both TyG index(aOR=198.65, 95% CI: 66.73-591.41, P<0.001)and TyG-BMI(aOR=1.03, 95% CI: 1.02-1.04, P<0.001)remained independently positive associated with DR. Quartile analysis indicated a progressive increase in DR risk with ascending quartiles of TyG index and TyG-BMI(all Ptrend<0.001). In contrast, HOMA-IR was not significantly associated with DR. Restricted cubic spline analysis, fully adjusted for confounders, showed a nonlinear upward trend in DR risk with increasing TyG index(Pnonlinearity<0.001), whereas TyG-BMI exhibited a U-shaped association(Pnonlinearity<0.05). No significant association was found between HOMA-IR and DR after propensity score matching. Receiver operating characteristic(ROC)curve demonstrated area under curve(AUC)values of 0.870(95% CI: 0.839-0.901)for TyG index, 0.710(95% CI: 0.665-0.755)for TyG-BMI, and 0.657(95% CI: 0.608-0.706)for HOMA-IR.CONCLUSION:The TyG index and TyG-BMI are risk factors for DR. A dose-dependent increase in DR risk was associated with elevated TyG index values. TyG-BMI exhibited an inverted U-shaped relationship with DR risk. The TyG index had better diagnostic efficiency for DR compared to both TyG-BMI and HOMA-IR index.

OBJECTIVE To explore the epidemiological characteristics of common allergens among children with al-lergic rhinitis(AR)in a children's specialized hospital of Beijing.METHODS A total of 2120 children who met the diagnostic criteria of AR and were treated in otolaryngology department of Beijing Jingdu Children's Hospital from 2021 to 2023 were recruited as the research subjects.The specific immunoglobulin E(sIgE)of allergens was de-tected by western blot quantitative assay.The positive rates of the allergens were statistically analyzed according to the age,sex and years.The epidemiological characteristics and changing trends were observed.RESULTS The pos-itive rate of allergens was 47.78％among the 2120 children,in whom multiple allergies polysensitization were pre-dominant;the positive rate of allergens and polysensitization rate were the highest among the population aged be-tween 1 and 7 years old.The inhalational allergens were dominant,and the positive rate of the Candida group was highest.The positive rates of inhalant allergens and ingested allergens reached the peak at the age of 1-7 and then declined with age;milk and egg white were the two types of predominant ingested allergens in childhood.Among the 2120 children,there were significant differences in the positive rates of allergens between the male and the fe-male,and the positive rates of the male were higher than those of the female(P＜0.001).The positive rates of al-lergens generally showed upward trends during the 3 years,the positive rates of the inhalant allergens such as mugwort,cat hair and dog dandruff ascended by a large margin,and the positive rates of the ingested allergens such as milk,egg white and egg yolk showed remarkable rising trends.CONCLUSIONS The causes of AR are complicated.There are a variety of factors affecting the allergen test.The epidemiological characteristics of the al-lergens among the AR children are observed from multiple perspectives,which may provide references for preven-tion and treatment of the children with AR.

Objective:To investigate the effects of preoperative visit in operating room based on"internet plus"on perioperative negative emotion,sleep quality and stress response of elderly patients.Methods:142 elderly patients who underwent surgery in the Yancheng No.1 People's Hospital from From February 2022 to February 2024 were selected,the patients were randomly divided into observation group(n=71,preoperative visit in operating room based on"internet plus")and control group(n=71,traditional preoper ative visit).The perioperative indicators(heart rate,systolic blood pressure,diastolic blood pressure),negative emotions[Self Rating Anxiety Scale(SAS),Self Rating Depression Scale(SDS)],sleep quality[Pittsburgh Sleep Quality Index(PSQI)score],stress response indicators[C-reactive protein(CRP),cortisol(Cor),norepinephrine(NE),epinephrine(E)]were compared between the two groups.Results:Heart rate after intervention increased,systolic blood pressure,diastolic blood pressure,SAS,SDS scores,PSQI scores,CRP,Cor,NE and E decreased,and the change range of observation group was greater than that of control group(P＜0.05).Conclusion:Preoperative visit in operating room based on"internet plus"can effectively reduce the negative emotions of elderly patients,improve the quality of sleep,and alleviate the stress reaction through early communication,rich information,convenient,efficient and personalized service.

Objective To investigate the risk factors of hemodynamic instability after carotid artery stenting by meta-analysis.Methods Ten databases were searched:PubMed,ProQuest,ScienceDirect,Embase,Cochrane Library,Web of Science,China Knowledge Network,Wanfang Data,VIP Information Database,and China Biomedical Database.The search date was from inception until 2 February 2024,and meta-analysis was performed using Stata 16.0 statistical software.Results A total of 27 studies with 4199 subjects and 22 influencing factors were included.The studies showed a 37.4％(95％CI 30.3％-44.8％)incidence of haemodynamic instability after carotid stenting,Meta-analysis determined that age＞60 years(P＜0.001),hypertension(P＜0.001),calcified plaque(P＜0.001),stenosis＞70％(P=0.008),eccentric plaque(P=0.002),distance from the largest stenosis to the carotid bifurcation≤ 10 mm(P＜0.001),stenosis involvement of the balloon or bifurcation(P＜0.001),balloon post-dilation(P=0.003),open-loop stenting(P＜0.001),dilated balloon diameter≥5 mm(P=0.002),repeat balloon dilation(P=0.011)and balloon dilation pressure≥8 atm(P＜0.001)are risk factors for intraoperative and postoperative haemodynamic instability in patients undergoing carotid artery stenting surgery.Statin use was a protective factor(P＜0.001).Conclusions Medical staff working in the clinic should assess the patient's condition preoperatively,identify risk factors that may lead to haemodynamic instability,and avoid unnecessary intraoperative stimulation of patients who are already in a high-risk state.Reduce postoperative clinical complications in patients with carotid artery stenosis and improve patient recovery.

OBJECTIVE To explore the epidemiological characteristics of common allergens among children with al-lergic rhinitis(AR)in a children's specialized hospital of Beijing.METHODS A total of 2120 children who met the diagnostic criteria of AR and were treated in otolaryngology department of Beijing Jingdu Children's Hospital from 2021 to 2023 were recruited as the research subjects.The specific immunoglobulin E(sIgE)of allergens was de-tected by western blot quantitative assay.The positive rates of the allergens were statistically analyzed according to the age,sex and years.The epidemiological characteristics and changing trends were observed.RESULTS The pos-itive rate of allergens was 47.78％among the 2120 children,in whom multiple allergies polysensitization were pre-dominant;the positive rate of allergens and polysensitization rate were the highest among the population aged be-tween 1 and 7 years old.The inhalational allergens were dominant,and the positive rate of the Candida group was highest.The positive rates of inhalant allergens and ingested allergens reached the peak at the age of 1-7 and then declined with age;milk and egg white were the two types of predominant ingested allergens in childhood.Among the 2120 children,there were significant differences in the positive rates of allergens between the male and the fe-male,and the positive rates of the male were higher than those of the female(P＜0.001).The positive rates of al-lergens generally showed upward trends during the 3 years,the positive rates of the inhalant allergens such as mugwort,cat hair and dog dandruff ascended by a large margin,and the positive rates of the ingested allergens such as milk,egg white and egg yolk showed remarkable rising trends.CONCLUSIONS The causes of AR are complicated.There are a variety of factors affecting the allergen test.The epidemiological characteristics of the al-lergens among the AR children are observed from multiple perspectives,which may provide references for preven-tion and treatment of the children with AR.

Objective To investigate the distribution and antimicrobial resistance profiles of common pathogens isolated from cerebrospinal fluid(CSF)in CHINET program from 2015 to 2021.Methods The bacterial strains isolated from CSF were identified in accordance with clinical microbiology practice standards.Antimicrobial susceptibility test was conducted using Kirby-Bauer method and automated systems per the unified CHINET protocol.Results A total of 14 014 bacterial strains were isolated from CSF samples from 2015 to 2021,including the strains isolated from inpatients(95.3％)and from outpatient and emergency care patients(4.7％).Overall,19.6％of the isolates were from children and 80.4％were from adults.Gram-positive and Gram-negative bacteria accounted for 68.0％and 32.0％,respectively.Coagulase negative Staphylococcus accounted for 73.0％of the total Gram-positive bacterial isolates.The prevalence of MRSA was 38.2％in children and 45.6％in adults.The prevalence of MRCNS was 67.6％in adults and 69.5％in children.A small number of vancomycin-resistant Enterococcus faecium(2.2％)and linezolid-resistant Enterococcus faecalis(3.1％)were isolated from adult patients.The resistance rates of Escherichia coli and Klebsiella pneumoniae to ceftriaxone were 52.2％and 76.4％in children,70.5％and 63.5％in adults.The prevalence of carbapenem-resistant E.coli and K.pneumoniae(CRKP)was 1.3％and 47.7％in children,6.4％and 47.9％in adults.The prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)and Pseudomonas aeruginosa(CRPA)was 74.0％and 37.1％in children,81.7％and 39.9％in adults.Conclusions The data derived from antimicrobial resistance surveillance are crucial for clinicians to make evidence-based decisions regarding antibiotic therapy.Attention should be paid to the Gram-negative bacteria,especially CRKP and CRAB in central nervous system(CNS)infections.Ongoing antimicrobial resistance surveillance is helpful for optimizing antibiotic use in CNS infections.

Objective To investigate the antimicrobial resistance of clinical isolates from elderly patients(≥65 years)in major medical institutions across China.Methods Bacterial strains were isolated from elderly patients in 52 hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program during the period from 2015 to 2021.Antimicrobial susceptibility test was carried out by disk diffusion method and automated systems according to the same CHINET protocol.The data were interpreted in accordance with the breakpoints recommended by the Clinical and Laboratory Standards Institute(CLSI)in 2021.Results A total of 514 715 nonduplicate clinical isolates were collected from elderly patients in 52 hospitals from January 1,2015 to December 31,2021.The number of isolates accounted for 34.3％of the total number of clinical isolates from all patients.Overall,21.8％of the 514 715 strains were gram-positive bacteria,and 78.2％were gram-negative bacteria.Majority(90.9％)of the strains were isolated from inpatients.About 42.9％of the strains were isolated from respiratory specimens,and 22.9％were isolated from urine.More than half(60.7％)of the strains were isolated from male patients,and 39.3％isolated from females.About 51.1％of the strains were isolated from patients aged 65-＜75 years.The prevalence of methicillin-resistant strains(MRSA)was 38.8％in 32 190 strains of Staphylococcus aureus.No vancomycin-or linezolid-resistant strains were found.The resistance rate of E.faecalis to most antibiotics was significantly lower than that of Enterococcus faecium,but a few vancomycin-resistant strains(0.2％,1.5％)and linezolid-resistant strains(3.4％,0.3％)were found in E.faecalis and E.faecium.The prevalence of penicillin-susceptible S.pneumoniae(PSSP),penicillin-intermediate S.pneumoniae(PISP),and penicillin-resistant S.pneumoniae(PRSP)was 94.3％,4.0％,and 1.7％in nonmeningitis S.pneumoniae isolates.The resistance rates of Klebsiella spp.(Klebsiella pneumoniae 93.2％)to imipenem and meropenem were 20.9％and 22.3％,respectively.Other Enterobacterales species were highly sensitive to carbapenem antibiotics.Only 1.7％-7.8％of other Enterobacterales strains were resistant to carbapenems.The resistance rates of Acinetobacter spp.(Acinetobacter baumannii 90.6％)to imipenem and meropenem were 68.4％and 70.6％respectively,while 28.5％and 24.3％of P.aeruginosa strains were resistant to imipenem and meropenem,respectively.Conclusions The number of clinical isolates from elderly patients is increasing year by year,especially in the 65-＜75 age group.Respiratory tract isolates were more prevalent in male elderly patients,and urinary tract isolates were more prevalent in female elderly patients.Klebsiella isolates were increasingly resistant to multiple antimicrobial agents,especially carbapenems.Antimicrobial resistance surveillance is helpful for accurate empirical antimicrobial therapy in elderly patients.

Objective:To investigate the effects of preoperative visit in operating room based on"internet plus"on perioperative negative emotion,sleep quality and stress response of elderly patients.Methods:142 elderly patients who underwent surgery in the Yancheng No.1 People's Hospital from From February 2022 to February 2024 were selected,the patients were randomly divided into observation group(n=71,preoperative visit in operating room based on"internet plus")and control group(n=71,traditional preoper ative visit).The perioperative indicators(heart rate,systolic blood pressure,diastolic blood pressure),negative emotions[Self Rating Anxiety Scale(SAS),Self Rating Depression Scale(SDS)],sleep quality[Pittsburgh Sleep Quality Index(PSQI)score],stress response indicators[C-reactive protein(CRP),cortisol(Cor),norepinephrine(NE),epinephrine(E)]were compared between the two groups.Results:Heart rate after intervention increased,systolic blood pressure,diastolic blood pressure,SAS,SDS scores,PSQI scores,CRP,Cor,NE and E decreased,and the change range of observation group was greater than that of control group(P＜0.05).Conclusion:Preoperative visit in operating room based on"internet plus"can effectively reduce the negative emotions of elderly patients,improve the quality of sleep,and alleviate the stress reaction through early communication,rich information,convenient,efficient and personalized service.

Objective To investigate the distribution and antimicrobial resistance profiles of common pathogens isolated from cerebrospinal fluid(CSF)in CHINET program from 2015 to 2021.Methods The bacterial strains isolated from CSF were identified in accordance with clinical microbiology practice standards.Antimicrobial susceptibility test was conducted using Kirby-Bauer method and automated systems per the unified CHINET protocol.Results A total of 14 014 bacterial strains were isolated from CSF samples from 2015 to 2021,including the strains isolated from inpatients(95.3％)and from outpatient and emergency care patients(4.7％).Overall,19.6％of the isolates were from children and 80.4％were from adults.Gram-positive and Gram-negative bacteria accounted for 68.0％and 32.0％,respectively.Coagulase negative Staphylococcus accounted for 73.0％of the total Gram-positive bacterial isolates.The prevalence of MRSA was 38.2％in children and 45.6％in adults.The prevalence of MRCNS was 67.6％in adults and 69.5％in children.A small number of vancomycin-resistant Enterococcus faecium(2.2％)and linezolid-resistant Enterococcus faecalis(3.1％)were isolated from adult patients.The resistance rates of Escherichia coli and Klebsiella pneumoniae to ceftriaxone were 52.2％and 76.4％in children,70.5％and 63.5％in adults.The prevalence of carbapenem-resistant E.coli and K.pneumoniae(CRKP)was 1.3％and 47.7％in children,6.4％and 47.9％in adults.The prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)and Pseudomonas aeruginosa(CRPA)was 74.0％and 37.1％in children,81.7％and 39.9％in adults.Conclusions The data derived from antimicrobial resistance surveillance are crucial for clinicians to make evidence-based decisions regarding antibiotic therapy.Attention should be paid to the Gram-negative bacteria,especially CRKP and CRAB in central nervous system(CNS)infections.Ongoing antimicrobial resistance surveillance is helpful for optimizing antibiotic use in CNS infections.

Objective To investigate the antimicrobial resistance of clinical isolates from elderly patients(≥65 years)in major medical institutions across China.Methods Bacterial strains were isolated from elderly patients in 52 hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program during the period from 2015 to 2021.Antimicrobial susceptibility test was carried out by disk diffusion method and automated systems according to the same CHINET protocol.The data were interpreted in accordance with the breakpoints recommended by the Clinical and Laboratory Standards Institute(CLSI)in 2021.Results A total of 514 715 nonduplicate clinical isolates were collected from elderly patients in 52 hospitals from January 1,2015 to December 31,2021.The number of isolates accounted for 34.3％of the total number of clinical isolates from all patients.Overall,21.8％of the 514 715 strains were gram-positive bacteria,and 78.2％were gram-negative bacteria.Majority(90.9％)of the strains were isolated from inpatients.About 42.9％of the strains were isolated from respiratory specimens,and 22.9％were isolated from urine.More than half(60.7％)of the strains were isolated from male patients,and 39.3％isolated from females.About 51.1％of the strains were isolated from patients aged 65-＜75 years.The prevalence of methicillin-resistant strains(MRSA)was 38.8％in 32 190 strains of Staphylococcus aureus.No vancomycin-or linezolid-resistant strains were found.The resistance rate of E.faecalis to most antibiotics was significantly lower than that of Enterococcus faecium,but a few vancomycin-resistant strains(0.2％,1.5％)and linezolid-resistant strains(3.4％,0.3％)were found in E.faecalis and E.faecium.The prevalence of penicillin-susceptible S.pneumoniae(PSSP),penicillin-intermediate S.pneumoniae(PISP),and penicillin-resistant S.pneumoniae(PRSP)was 94.3％,4.0％,and 1.7％in nonmeningitis S.pneumoniae isolates.The resistance rates of Klebsiella spp.(Klebsiella pneumoniae 93.2％)to imipenem and meropenem were 20.9％and 22.3％,respectively.Other Enterobacterales species were highly sensitive to carbapenem antibiotics.Only 1.7％-7.8％of other Enterobacterales strains were resistant to carbapenems.The resistance rates of Acinetobacter spp.(Acinetobacter baumannii 90.6％)to imipenem and meropenem were 68.4％and 70.6％respectively,while 28.5％and 24.3％of P.aeruginosa strains were resistant to imipenem and meropenem,respectively.Conclusions The number of clinical isolates from elderly patients is increasing year by year,especially in the 65-＜75 age group.Respiratory tract isolates were more prevalent in male elderly patients,and urinary tract isolates were more prevalent in female elderly patients.Klebsiella isolates were increasingly resistant to multiple antimicrobial agents,especially carbapenems.Antimicrobial resistance surveillance is helpful for accurate empirical antimicrobial therapy in elderly patients.