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.

Background/Aims: Chronic hepatitis C (CHC) patients who failed antiviral therapy are at increased risk for hepatocellular carcinoma (HCC). This study assessed the potential role of metformin and statins, medications for diabetes mellitus (DM) and hyperlipidemia (HLP), in reducing HCC risk among these patients. Methods: We included CHC patients from the T-COACH study who failed antiviral therapy. We tracked the onset of HCC 1.5 years post-therapy by linking to Taiwan’s cancer registry data from 2003 to 2019. We accounted for death and liver transplantation as competing risks and employed Gray’s cumulative incidence and Cox subdistribution hazards models to analyze HCC development. Results: Out of 2,779 patients, 480 (17.3%) developed HCC post-therapy. DM patients not using metformin had a 51% increased risk of HCC compared to non-DM patients, while HLP patients on statins had a 50% reduced risk compared to those without HLP. The 5-year HCC incidence was significantly higher for metformin non-users (16.5%) versus non-DM patients (11.3%; adjusted sub-distribution hazard ratio [aSHR]=1.51; P=0.007) and metformin users (3.1%; aSHR=1.59; P=0.022). Statin use in HLP patients correlated with a lower HCC risk (3.8%) compared to non-HLP patients (12.5%; aSHR=0.50; P<0.001). Notably, the increased HCC risk associated with non-use of metformin was primarily seen in non-cirrhotic patients, whereas statins decreased HCC risk in both cirrhotic and non-cirrhotic patients. Conclusions Metformin and statins may have a chemopreventive effect against HCC in CHC patients who failed antiviral therapy. These results support the need for personalized preventive strategies in managing HCC risk.

Objective:To examine the effect of anemia on the prognosis of elderly patients with acute coronary syndrome.Methods:We searched PubMed, Scopus, OVID, the Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure, China Biology Medicine Disc, the WanFang and Weipu databases for studies on the association between anemia and the prognosis of acute coronary syndrome in elderly patients.The date range included the period from the establishment of the database to December 10, 2022.Two reviewers independently completed the literature screening and data extraction according to the inclusion and exclusion criteria for the literature.Stata 16.0 software was used to analyze the data.Results:Of 1 399 references retrieved from the initial search, 13 met the inclusion criteria, including a total of 9540 patients with a mean age of 70.3 years.2872 of these patients had concurrent anemia and 6 668 patients had no anemia.In elderly patients with acute coronary syndrome, those with anemia showed significantly increased risk of death, compared with those with no anemia( RR=2.28, 95% CI: 1.74-3.00). Anemia also increased the incidence of ischemia( RR=1.36, 95% CI: 1.13-1.64)and bleeding events( RR=2.18, 95% CI: 1.59-3.01)( P<0.05 for all). Conclusions:Anemia significantly increases the risk of death and is associated with poor prognosis in elderly patients with acute coronary syndrome.

Objective: This study sought to investigate the impact of different obesity patterns on coronary microvascular function in male patients with non-obstructive coronary artery disease. Methods: We retrospectively analyzed clinical data of male patients diagnosed with suspected coronary microvascular dysfunction (CMD) in the First Hospital of Shanxi Medical University between December 2015 and August 2021. All patients underwent the one-day rest and stress ¹³N-ammonia positron emission tomography myocardial perfusion imaging. Overall obesity was defined by body mass index (BMI) ≥28 kg/m² and abdominal obesity was defined by waist circumference ≥90 cm. Hyperemic myocardial blood flow (MBF)<2.3 ml·min^-1·g^-1 or coronary flow reserve (CFR)<2.5 were referred as CMD. All patients were grouped based on their BMI and waist circumference. MBF, CFR, the incidence of CMD, hemodynamic parameters, and cardiac function were compared among the groups. Results: A total of 136 patients were included. According to BMI and waist circumference, patients were categorized into 3 groups: control group (n=45), simple abdominal obesity group (n=53) and compound obesity group (n=38). Resting MBF did not differ between groups (F=0.02,P=0.994). Compared with the control group, hyperemic MBF was significantly lower in the simple abdominal obesity and compound obesity groups ((2.82±0.64) ml·min^-1·g^-1, (2.44±0.85) ml·min^-1·g^-1 and (2.49±0.71) ml·min^-1·g^-1, both P<0.05, respectively). Hyperemic MBF was comparable among the groups of patients with obesity (P=0.772). CFR was significantly lower in the simle abdominal obesity group compared with the control group (2.87±0.99 vs. 3.32±0.62,P=0.012). Compared with the control group, CFR tended to be lower in the compound obesity group (3.02±0.91 vs. 3.32±0.62,P=0.117). The incidence of CMD was significantly higher in both the simple abdominal obesity and compound obesity groups than in the control group (62.3%, 52.6% vs. 22.2%, both P<0.01, respectively). Waist circumference was an independent risk factor for male CMD (OR=1.057, 95%CI: 1.013-1.103, P=0.011). Conclusions: In male patients with non-obstructive coronary artery disease, abdominal obesity is associated with decreased coronary microvascular function. Male patients with simple abdominal obesity face the highest risk of CMD.
Humans ; Male ; Coronary Artery Disease ; Coronary Circulation/physiology* ; Obesity, Abdominal ; Retrospective Studies ; Obesity/epidemiology* ; Hyperemia

Objective: To investigate hypertriglyceridemia and hepatomegaly caused by Schisandrae Sphenantherae Fructus (FSS) and Schisandra chinensis Fructus (FSC) oils in mice. Methods: Mice were orally administered a single dose of Schisandrae Fructus oils. Serum and hepatic triglyceride (TG), triglyceride transfer protein (TTP), apolipoprotein B48 (Apo B48), very-low-density lipoprotein (VLDL), hepatocyte growth factor (HGF), alanine aminotransfease (ALT) and liver index were measured at 6-120 h post-dosing. Results: FSS and FSC oil caused time and dose-dependent increases in serum and hepatic TG levels, with maximum increases in the liver (by 297% and 340%) at 12 h post-dosing and serum (244% and 439%) at 24-h post-dosing, respectively. Schisandrae Fructus oil treatments also elevated the levels of serum TTP by 51% and 63%, Apo B48 by 152% and 425%, and VLDL by 67% and 38% in mice, respectively. FSS and FSC oil treatments also increased liver mass by 53% and 55% and HGF by 106% and 174%, but lowered serum ALT activity by 38% and 22%, respectively. Fenofibrate pre/ co-treatment attenuated the FSS and FSC oil-induced elevation in serum TG levels by 41% and 49% at 48 h post-dosing, respectively, but increased hepatic TG contents (by 38% and 33%, respectively) at 12 h post-dosing. Conclusions: Our findings provide evidence to support the establishment of a novel mouse model of hypertriglyceridemia by oral administration of FSS oil (mainly increasing endogenous TG) and FSC oil (mainly elevating exogenous TG).

Objective Apolipoprotein E (APOE) is mainly involved in lipid metabolism and cholesterol transport, which is important for health. To establish a pyrosequencing based method for detection of 112T>C and 158C>T single nucleotide polymorphisms (SNPs) in Apolipoprotein E gene. Methods Three amplification systems including Taq enzyme buffer from TaKaRa company (T buffer), La Taq enzyme buffer specified for G-C rich regions (L buffer) and Trans Taq enzyme buffer from TransGen company (TT buffer) were chosen to optimize PCR system and temperature by annealing at 60 °C and gradient annealing from 62 to 68 °C respectively. The specificity of this method was evaluated by comparing its results with those of Sanger sequencing. The sensitivity of this method was evaluated by gradient diluting human genomic DNA as detection template. Results According to the concentration and specificity of the products, the optimum condition was L buffer with 60℃ annealing programs. Pyrosequencing results of 20 samples were completely consistent with those of Sanger sequencing. The sensitivity of this method could be as low as 0.16 ng genomic DNA. Conclusion A method based on pyrosequencing detecting 112 and 158 polymorphisms in APOE gene was established, which can be applied in clinical personalized medicine.

OBJECTIVE: To observe the effects on hippocampal neuronal structure and hippocampal monoamine neurotransmitters such as norepinephrine (NE), 5-hydroxytryptamine (5-HT) and dopamine (DA) with acupuncture for promoting the circulation of the governor vessel and regulating the mental state ( acupuncture) in rats with post-stroke depression and explore the underlying effect mechanism of acupuncture on post-stroke depression. METHODS: A total of 48 clean-grade SD rats were randomized into a sham-operation group, a model group, a Tongdu Tiaoshen acupuncture group and a non-meridian-non-acupoint group, 12 rats in each one. In the model group, the Tongdu Tiaoshen acupuncture group and the non-meridian-non-acupoint group, the compound method of cerebral medial arterial occlusion and the chronic unpredictable mild stress was adopted to prepare the model of post-stroke depression. In the sham-operation group, skin was opened and the fascia muscle was separated, after artery exposed, no ligation was operated and the incision was sutured directly. In the sham-operation group and the model group, no any intervention was performed. In the Tongdu Tiaoshen acupuncture group, acupuncture was applied to "Baihui" (GV 20), "Shuigou" (GV 26), "Shenting" (CV 24) and "Dazhui" (GV 14) for 40 min in each treatment and the needles were manipulated at the acupoints once in 20 min. The treatment was given once a day, 6 times a week for 4 weeks consecutively. In the non-meridian-non-acupoint group, the depression between the 3rd and 4th metatarsal bones on the dorsum of the forelimb was selected in intervention and the needling technique was same as the Tongdu Tiaoshen acupuncture group. The behavioral changes were observed after intervention in each group. Using transmission electron microscopy, the ultrastructure of hippocampal CA 1 neurons was observed in the rats of each group. Using high performance liquid chromatography, the contents of NE, 5-HT and DA were determined. RESULTS: Compared with the sham-operation group, the Zea-longa neurobehavioral score was increased (<0.01), the sucrose water consumption was reduced (<0.01), the number of times of horizontal movement and vertical movement in open-field test were reduced (both <0.01), the damage of the ultrastructure of hippocampal CA 1 neurons was aggravated and the contents of NE, 5-HT and DA were reduced in the model group (<0.01). Compared with the model group, the Zea-Longa neurobehavioral score was reduced (<0.01), the sucrose water consumption was increased (<0.01), the number of times of horizontal movement and vertical movement in open-field test were increased (both <0.01), the damage of the ultrastructure of hippocampal CA 1 neurons was alleviated and the contents of NE, 5-HT and DA were increased in the Tongdu Tiaoshen acupuncture group (<0.01, <0.05). Compared with the non-meridian-non-acupoint group, the Zea-Longa neurobehavioral score was reduced (<0.01), the sucrose water consumption was increased (<0.01), the number of times of horizontal movement and vertical movement in open-field test were increased (both <0.01), the damage of the ultrastructure of hippocampal CA 1 neurons was alleviated and the contents of NE, 5-HT and DA were increased in the Tongdu Tiaoshen acupuncture group (<0.01, <0.05). CONCLUSION The acupuncture improves the behavior of the model rats with post-stroke depression, repairs hippocampal neuronal damage, which is probably related to the contents of hippocampal monoamine neurotransmitters (NE, 5-HT and DA).
Acupuncture Therapy ; Animals ; Depression ; Hippocampus ; Neurons ; Neurotransmitter Agents ; Rats ; Rats, Sprague-Dawley ; Stroke

Volatile organic compounds (VOCs) in ambient air can participate in photochemical reactions, which lead to the generation of secondary pollutants such as ozone and aerosol. So real-time and accurate monitoring of atmospheric VOCs plays an important role in the study of the causes of air pollution. On the basis of proton transfer reaction mass spectrometry (PTR-MS) research, a novel dipolar proton transfer reaction mass spectrometer (DP-PTR-MS) for real-time and on-line monitoring atmospheric VOCs was developed. Compared with the conventional PTR-MS with one kind of reagent ion H3O+, DP-PTR-MS had three kinds of reagent ions H3O+, OH-, (CH)2COH+, which could be switched according to the actual detection need. So DP-PTR-MS can improve the qualitative ability and expand the detection range effectively. The reagent ion H3O+can be used for detecting VOCs whose proton affinities are greater than that of H2O. The reagent ion OH-can be used to identify VOCs cooperating with the reagent ion H3O+,and can also be used for detecting some inorganic substances such as CO2. The reagent ion (CH3)2COH+can be used for accurately detecting NH3under interference elimination circumstances. The limit of detection (LOD) and sensitivity of DP-PTR-MS were measured by using six kinds of standard gases. The results showed that the LOD for detecting toluene was 7×10-12(V/V) and the sensitivity for detecting ammonia has reached 126 cps/10-9 (V/V). The ambient air in Hefei city was on-line and real-time monitored for continuous 78 hours with DP-PTR-MS. The results showed that the newly developed DP-PTR-MS could be used for long-term and real-time monitoring atmospheric VOCs with the concentration of 10-12(V/V) level. DP-PTR-MS is an important tool for the study of the causes of atmospheric pollution and the monitoring of trace VOCs emissions.

Objective To investigate the spectrum and antimicrobial resistance of major pathogens causing nosocomial infections in China, 2016. Methods Non-duplicated nosocomial cases as well as pathogens causing bloodstream infections ( BSI) , hospital-acquired pneumonia ( HAP) and intra-abdominal infections ( IAI ) from 12 teaching hospitals across China were collected. The minimum inhibitory concentrations (MICs) of important clinical common strains were determined by agar dilution method or broth microdilution method. The CLSI M100-S27 criteria was used for interpretation. Data were analyzed by using WHONET-5. 6 software. Results A total of 2060 cases were collected, including 894 cases from BSI, 630 cases from HAP and 536 cases from IAI. The MICs of 1896 important clinical common strains were determined. Escherichia coli and Klebsiella pneumoniae were the most prevalent pathogens causing BSI and IAI, while Acinetobacter baumanii and Pseudomonas aeruginosa were dominated in HAP. All Staphylococcus aureus were susceptible to tigecycline, linezolid, daptomycin and glycopeptides. Methicillin-resistant S. aureus accounted for 44. 4％ ( 75/169 ) of all the S. aureus. The rate of methicillin-resistant coagulase-negative staphylococci was 80. 9％ ( 72/89 ) . No Enterococcus strains were found resistant to tigecycline, linezolid or daptomycin. Vacomycin resistant enterococcus was found in Enterococcus faecium, accounting for 1. 8％ ( 2/111 ) of all E. faecium strains. Tigecycline, meropenem, amikacin, imipenem, and polymyxin B exhibited high potency against Enterobacteriaceae and the susceptibility rates were 96. 6％(865/895), 94. 3％ (859/911), 94. 2％ (858/911), 94. 1％ (857/911), and 91. 6％ (820/895), respectively. The prevalence of extended-spectrum β-lactamase was 58. 4％ ( 263/450 ) in E. coli and 28. 6％ ( 84/294 ) in K. pneumonia. The rate of carbapenem resistant K. pneumonia and E. coli was 15. 3％ ( 45/294 ) and 1. 8％ ( 8/450 ) , respectively. The percentage of polymyxin B resistant K. pneumonia and E. coli was 4. 1％ ( 12/294 ) and 4. 4％ ( 20/450 ) , respectively. The rate of tigecycline resistant K. pneumonia and E. coli was 2. 4％ ( 7/294 ) and 0. 2％ ( 1/450 ) , respectively. A. baumanii showed low susceptibility to the antimicrobial agents except tigecycline ( 91. 4％, 235/257 ) and polymyxin B (100％, 257/257). The rate of carbapenem resistant A. baumanii was 80. 5％ (207/257). The rate of carbapenem resistant P. aeruginosa was 31. 7％ ( 59/186 ) . Polymyxin B and amikacin demonstrated high antibacterial activity against P. aeruginosa with susceptility rate of 100％ ( 186/186 ) and 90. 9％ ( 169/186), respectively. Conclusions Nosocomial pathogens showed high susceptibilities against tigecycline and polymyxin B. Antimicrobial resistance in A. baumannii is a serious problem. The prevalence of carbapenem-resistant Enterobacteriaceae and polymyxin B resistant Enterobacteriaceae has increased, which should be monitored continuously in China.