Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2023.Methods Clinical isolates collected from 73 hospitals across China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2023 Clinical & Laboratory Standards Institute (CLSI) breakpoints.Results A total of 445199 clinical isolates were collected in 2023,of which 29.0％ were gram-positive and 71.0％ 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) (MRSA,MRSE and MRCNS) was 29.6％,81.9％ and 78.5％,respectively.Methicillin-resistant strains showed significantly higher resistance rates to most antimicrobial agents than methicillin-susceptible strains (MSSA,MSSE and MSCNS).Overall,92.9％ of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 91.4％ of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis had 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 93.1％ in the isolates from children and and 95.9％ in the isolates from adults.The resistance rate to carbapenems was lower than 15.0％ for most Enterobacterales species except for Klebsiella,22.5％ and 23.6％ of which were resistant to imipenem and meropenem,respectively .Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.6％ to 10.0％.The resistance rate to imipenem and meropenem was 21.9％ and 17.4％ for Pseudomonas aeruginosa,respectively,and 67.5％ and 68.1％ for Acinetobacter baumannii,respectively.Conclusions Increasing resistance to the commonly used antimicrobial agents is still observed in clinical bacterial isolates.However,the prevalence of important crabapenem-resistant organisms such as crabapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a slightly decreasing trend.This finding suggests that strengthening bacterial resistance surveillance and multidisciplinary linkage are important for preventing the occurrence and development of bacterial resistance.

Objective To analysis the current situation of clinical pathway implementation and management of 53 public general hospitals in 16 cities in Anhui Province from 2018 to 2021,so as to provide a basis for further strengthening the management of clinical pathways in Anhui Province.Methods From December 2022 to March 2023,questionnaire stars were used to conduct a questionnaire survey on the implementation status of clinical pathway management.Results In 2021,53 public general hospitals implemented an average of 23.56 clinical pathways,228.75 diseases,88.58％ of the average admission rate,69.08％ of the average coverage rate,and 92.85％ of the average completion rate,meeting the national requirements. However,the number of departments,coverage and completion rate showed a small increase over the past four years.The hospital level,the time of information system implementation,the position of the clinical pathway leader,whether it is linked to departmental and individual bonuses,and the integration of clinical pathways with DRG/DIP payment methods all have statistically significant effects on the implementation effectiveness of clinical pathways(P<0.05).Conclusion Since the establishment of the Clinical Pathway Management Center in 2015,Anhui Province has promoted the implementation of clinical pathway management in the province's second-level and above public hospitals every year,but it has entered management after 2018.It is suggested that Anhui Province should strengthen the attention of hospital leaders,information management and the integration of clinical paths and medical insurance payment methods in the future,so as to achieve a balance between cost control and reasonable diagnosis and treatment.

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.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2023.Methods Clinical isolates collected from 73 hospitals across China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2023 Clinical & Laboratory Standards Institute (CLSI) breakpoints.Results A total of 445199 clinical isolates were collected in 2023,of which 29.0％ were gram-positive and 71.0％ 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) (MRSA,MRSE and MRCNS) was 29.6％,81.9％ and 78.5％,respectively.Methicillin-resistant strains showed significantly higher resistance rates to most antimicrobial agents than methicillin-susceptible strains (MSSA,MSSE and MSCNS).Overall,92.9％ of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 91.4％ of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis had 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 93.1％ in the isolates from children and and 95.9％ in the isolates from adults.The resistance rate to carbapenems was lower than 15.0％ for most Enterobacterales species except for Klebsiella,22.5％ and 23.6％ of which were resistant to imipenem and meropenem,respectively .Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.6％ to 10.0％.The resistance rate to imipenem and meropenem was 21.9％ and 17.4％ for Pseudomonas aeruginosa,respectively,and 67.5％ and 68.1％ for Acinetobacter baumannii,respectively.Conclusions Increasing resistance to the commonly used antimicrobial agents is still observed in clinical bacterial isolates.However,the prevalence of important crabapenem-resistant organisms such as crabapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a slightly decreasing trend.This finding suggests that strengthening bacterial resistance surveillance and multidisciplinary linkage are important for preventing the occurrence and development of bacterial resistance.

Objective To analysis the current situation of clinical pathway implementation and management of 53 public general hospitals in 16 cities in Anhui Province from 2018 to 2021,so as to provide a basis for further strengthening the management of clinical pathways in Anhui Province.Methods From December 2022 to March 2023,questionnaire stars were used to conduct a questionnaire survey on the implementation status of clinical pathway management.Results In 2021,53 public general hospitals implemented an average of 23.56 clinical pathways,228.75 diseases,88.58％ of the average admission rate,69.08％ of the average coverage rate,and 92.85％ of the average completion rate,meeting the national requirements. However,the number of departments,coverage and completion rate showed a small increase over the past four years.The hospital level,the time of information system implementation,the position of the clinical pathway leader,whether it is linked to departmental and individual bonuses,and the integration of clinical pathways with DRG/DIP payment methods all have statistically significant effects on the implementation effectiveness of clinical pathways(P<0.05).Conclusion Since the establishment of the Clinical Pathway Management Center in 2015,Anhui Province has promoted the implementation of clinical pathway management in the province's second-level and above public hospitals every year,but it has entered management after 2018.It is suggested that Anhui Province should strengthen the attention of hospital leaders,information management and the integration of clinical paths and medical insurance payment methods in the future,so as to achieve a balance between cost control and reasonable diagnosis and treatment.

Background: Inactivated vaccines are limited in preventing foot-and-mouth disease (FMD) due to safety problems. Recombinant virus-like particles (VLPs) are an excellent candidate for a novel vaccine for preventing FMD, given that VLPs have similar immunogenicity as natural viruses and are replication- and infection-incompetent. Objectives: The 3C protease and P1 polyprotein of type O FMD virus (FDMV) was expressed in yeast Hansenula polymorpha to generate self-resembling VLPs, and the potential of recombinant VLPs as an FMD vaccine was evaluated. Methods: BALB/c mice were immunized with recombinant purified VLPs using CpG oligodeoxynucleotide and aluminum hydroxide gel as an adjuvant. Cytokines and lymphocytes from serum and spleen were analyzed by enzyme-linked immunosorbent assay, enzyme-linked immunospot assay, and flow cytometry. Results: The VLPs of FMD were purified successfully from yeast protein with a diameter of approximately 25 nm. The immunization of mice showed that animals produced high levels of FMDV antibodies and a higher level of antibodies for a longer time. In addition, higher levels of interferon-γ and CD4 + T cells were observed in mice immunized with VLPs. Conclusions The expression of VLPs of FMD in H. polymorpha provides a novel strategy for the generation of the FMDV vaccine.

Cortical interneurons can be categorized into distinct populations based on multiple modalities, including molecular signatures and morpho-electrical (M/E) properties. Recently, many transcriptomic signatures based on single-cell RNA-seq have been identified in cortical interneurons. However, whether different interneuron populations defined by transcriptomic signature expressions correspond to distinct M/E subtypes is still unknown. Here, we applied the Patch-PCR approach to simultaneously obtain the M/E properties and messenger RNA (mRNA) expression of >600 interneurons in layer V of the mouse somatosensory cortex (S1). Subsequently, we identified 11 M/E subtypes, 9 neurochemical cell populations (NCs), and 20 transcriptomic cell populations (TCs) in this cortical lamina. Further analysis revealed that cells in many NCs and TCs comprised several M/E types and were difficult to clearly distinguish morpho-electrically. A similar analysis of layer V interneurons of mouse primary visual cortex (V1) and motor cortex (M1) gave results largely comparable to S1. Comparison between S1, V1, and M1 suggested that, compared to V1, S1 interneurons were morpho-electrically more similar to M1. Our study reveals the presence of substantial M/E variations in cortical interneuron populations defined by molecular expression.
Mice ; Animals ; Neocortex/physiology* ; Mice, Transgenic ; Interneurons/physiology*

Animals ; Brain Diseases/pathology* ; Cell Cycle ; Interneurons/pathology* ; Median Eminence/pathology* ; Mice

The status of lymph node metastasis is an important prognostic factor for many malignant tumors, including lung cancer. In the 8th edition of the TNM staging system for lung cancer, the T staging had obvious changes and refinements, but the N staging had little changes. Recently, several studies have found that the prognosis of patients with the same N stage can vary greatly, suggesting that a more detailed subgroup of patients with the same N stage should be subdivided, including the inclusion of extra-capsular lymph node metastases (ENE). In this review, we reviewed the definition, classification/grading, imaging diagnosis, pathological diagnosis, related molecular markers and their relationship with the prognosis of lung cancer patients.

Objective: To evaluate the efficacy of cognitive-behavioral therapy (CBT) combined with mirtazapine for patients with functional dyspepsia (FD). Methods: Totally 121 patients with FD who met Rome Ⅳ diagnostic criteria in clinic of clinical psychiatry of a general hospital were collected.They were randomly divided into combined treatment group(n=61) and single drug group(n=60). The treatment period was 8 weeks.All patients with FD were given mirtazapine.The combined treatment group received 8 times systemic CBT treatments at the same time.Symptom checklist-90 (SCL-90) and gastrointestinal integral scale (GIS) were evaluated in all patients before and after 8-week intervention. Results: After 8 weeks of intervention, the total score of SCL-90 scale, somatization, compulsion, depression, paranoia and other factors in the combined treatment group were lower than those in the single group(130.26±36.18 vs 147.95±45.55, 1.34±0.44 vs 1.51±0.5, 1.66±0.50 vs 1.90±0.66, 1.47±0.52 vs 1.69±0.63, 1.48±0.49 vs 1.70±0.61, 1.47±0.50 vs 1.73±0.68, respectively)(all P<0.05). After 8 weeks of intervention, the total score of the GIS scale in the combined treatment group (6.77±5.05 vs 9.49±5.24), vomiting (0.57±0.77 vs 0.88±0.91), spastic upper abdominal pain (0.43±0.74 vs 0.90±1.08) and post-sternal discomfort (0.57±0.89 vs 1.05±1.19) were significantly lower than that of the simple drug group after intervention(6.77±5.05 vs 9.49±5.24, 0.57±0.77 vs 0.88 ±0.91, 0.43±0.74 vs 0.90±1.08 and 0.57±0.89 vs 1.05±1.19, respectively), and the differences were statistically significant (all P<0.05). Conclusion CBT combined with mirtazapine in the treatment of FD is superior to drug therapy alone.CBT combined with mirtazapine can improve the emotional problems in the treatment of FD and further improving the digestive function.