Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective:To evaluate the effect of an opioid-sparing anesthesia strategy primarily using quadratus lumborum block combined with esketamine on early postoperative recovery in patients undergoing laparoscopic radical resection of colon cancer.Methods:This study was a randomized controlled trial. From January 2023 to July 2024, 72 patients of either sex, aged 45-65 yr, with body mass index of 18-25 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, undergoing elective laparoscopic radical resection of colon cancer with general anesthesia at Yichang Central People′s Hospital, were divided into 2 groups ( n=36 each) using a random number table method: control group (group C) and opioid-sparing anesthesia strategy group (group D). Anesthesia was induced with sufentanil and propofol and maintained with propofol and remifentanil in group C. In group D, ultrasound-guided quadratus lumborum block was performed before the start of anesthesia, and anesthesia was induced with esketamine, propofol and lidocaine and maintained with esketamine, propofol, low-dose remifentanil, lidocaine and magnesium sulfate. Patient-controlled intravenous analgesia was carried out at the end of surgery until 48 h postoperatively, using dezocine for rescue analgesia. The Quality of Recovery-15 scores were assessed and recorded at 1 day before operation and 1, 3 and 7 days after operation. Ramsay sedation scores were recorded at 2, 6, 12, 24 and 48 h after surgery. The effective pressing times of patient-controlled analgesia and requirement for rescue analgesia were recorded within 24 h after surgery and during the 24-48 h postoperative period. The intraoperative consumption of opioid, emergence time, duration of postanesthesia care unit stay, time to first flatus, first ambulation time and length of postoperative hospital stay were also recorded. The postoperative complications were recorded during hospital stay and assessed with the Clavien-Dindo classification. Results:Compared with group C, the Quality of Recovery-15 scores were significantly increased at each time point after operation, Ramsay sedation scores were increased at 2, 6 and 12 h after operation, the effective pressing times of patient-controlled analgesia and rate of rescue analgesia were decreased in each postoperative period, the intraoperative consumption of remifentanil was reduced, the time to first flatus, first ambulation time and length of postoperative hospital stay were shortened, the incidence of nausea and vomiting was decreased ( P<0.05), and no significant change was found in the emergence time or duration of postanesthesia care unit stay in group D ( P>0.05). Conclusions:The opioid-sparing anesthesia strategy primarily using quadratus lumborum block combined with esketamine can raise the quality of early postoperative recovery in the patients undergoing laparoscopic radical resection of colon cancer.

Objective:To observe the pregnancy outcomes of patients with unexplained recurrent spontaneous abortion (URSA) after interventional treatment or expectant treatment.Methods:This prospective study followed up 398 patients with recurrent spontaneous abortion from March 2017 to September 2022 in seven hospitals. Among them, 267 patients were diagnosed with URSA, including 124 patients who were initially diagnosed in the interventional treatment hospital and 143 patients who were initially diagnosed in the expectant treatment hospital. All URSA patients were followed up for 33 months. Ongoing pregnancy rates were observed as main outcome indicators.Results:A total of 127 patients became pregnant, and 107 of them had sustained pregnancies, the ongoing pregnancy rate was 84.25% (107/127). The ongoing pregnancy rate was 86.11% (31/36) in the interventional treatment group and 83.52% (76/91) in the expectant treatment group, with no significant difference ( P>0.05). During the follow-up, the ongoing pregnancy rates in the interventional treatment hospital and the expectant treatment hospital were 75.71% (53/70) and 94.74% (54/57), respectively, with a significant difference ( P<0.05). The ongoing pregnancy rate after interventional treatment in the interventional treatment hospital was 82.76% (24/29), which was similar to the 94.00% (47/50) after expectant treatment in the expectant treatment hospital ( P>0.05). Conclusion:The ongoing pregnancy rate of interventional treatment for URSA patients has not been significantly improved, suggesting that it may not be necessary to carry out this treatment.

Objective:To analyze the epidemiological characteristics and delay in detection of reported brucellosis cases in Nangang District of Harbin City, Heilongjiang Province, in order to provide a basis for improving targeted measures for brucellosis prevention and control.Methods:Data on brucellosis reported in Nangang District of Harbin City between 2018 and 2022 were obtained from the China Disease Prevention and Control Information System. A descriptive analysis was conducted to outline the epidemiological status, epidemiological features, and sources of cases. Seasonal patterns of brucellosis were assessed using the concentration degree and seasonal index methods. Joinpoint regression model was used to analyze the trend of delay in detection.Results:From 2018 to 2022, a total of 4 428 cases of brucellosis were reported in Nangang District, with 1 183 cases (26.72%) reported in 2018 and 528 cases (11.92%) reported in 2022. The gender ratio of the cases was 2.80 ∶ 1.00 (3 264 ∶ 1 164). Most cases occurred in individuals aged 30 to 59 years (73.19%, 3 241/4 428). Occupationally, farmers comprised the majority of cases (88.73%, 3 929/4 428), followed by homemakers/unemployed individuals (3.73%, 165/4 428), and students (2.03%, 90/4 428). Regarding case origin, 31.48% (1 394/4 428) were from Harbin City, while 64.97% (2 877/4 428) originated from other cities within Heilongjiang Province, predominantly from Suihua City (38.89%, 1 722/4 428). Additionally, 157 cases (3.55%, 157/4 428) were reported from outside Heilongjiang Province, all of which were from Inner Mongolia Autonomous Region and Jilin Province. Brucellosis incidence showed weak seasonality ( M = 0.230), with the epidemic period spanning from March to August. During this period, seasonal indices C exceeded 100%, peaking in July (168.02%). From 2018 to 2022, the average annual delay rate in case detection was 20.14% (892/4 428). The delayed detection rates of brucellosis cases in each year were 30.68% (363/1 183), 17.86% (200/1 120), 17.23% (117/679), 12.75% (117/918), and 17.99% (95/528), respectively (average annual percentage change = - 17.52%, P = 0.090). Conclusions:Brucellosis in Nangang District of Harbin Citydemonstrates weak seasonality, with peak incidence occurring from March to August. Detection delays remain a concern, highlighting the need for sustained surveillance and the implementation of integrated, multi-sectoral prevention and control measures.

Objective:To evaluate the effect of an opioid-sparing anesthesia strategy primarily using quadratus lumborum block combined with esketamine on early postoperative recovery in patients undergoing laparoscopic radical resection of colon cancer.Methods:This study was a randomized controlled trial. From January 2023 to July 2024, 72 patients of either sex, aged 45-65 yr, with body mass index of 18-25 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, undergoing elective laparoscopic radical resection of colon cancer with general anesthesia at Yichang Central People′s Hospital, were divided into 2 groups ( n=36 each) using a random number table method: control group (group C) and opioid-sparing anesthesia strategy group (group D). Anesthesia was induced with sufentanil and propofol and maintained with propofol and remifentanil in group C. In group D, ultrasound-guided quadratus lumborum block was performed before the start of anesthesia, and anesthesia was induced with esketamine, propofol and lidocaine and maintained with esketamine, propofol, low-dose remifentanil, lidocaine and magnesium sulfate. Patient-controlled intravenous analgesia was carried out at the end of surgery until 48 h postoperatively, using dezocine for rescue analgesia. The Quality of Recovery-15 scores were assessed and recorded at 1 day before operation and 1, 3 and 7 days after operation. Ramsay sedation scores were recorded at 2, 6, 12, 24 and 48 h after surgery. The effective pressing times of patient-controlled analgesia and requirement for rescue analgesia were recorded within 24 h after surgery and during the 24-48 h postoperative period. The intraoperative consumption of opioid, emergence time, duration of postanesthesia care unit stay, time to first flatus, first ambulation time and length of postoperative hospital stay were also recorded. The postoperative complications were recorded during hospital stay and assessed with the Clavien-Dindo classification. Results:Compared with group C, the Quality of Recovery-15 scores were significantly increased at each time point after operation, Ramsay sedation scores were increased at 2, 6 and 12 h after operation, the effective pressing times of patient-controlled analgesia and rate of rescue analgesia were decreased in each postoperative period, the intraoperative consumption of remifentanil was reduced, the time to first flatus, first ambulation time and length of postoperative hospital stay were shortened, the incidence of nausea and vomiting was decreased ( P<0.05), and no significant change was found in the emergence time or duration of postanesthesia care unit stay in group D ( P>0.05). Conclusions:The opioid-sparing anesthesia strategy primarily using quadratus lumborum block combined with esketamine can raise the quality of early postoperative recovery in the patients undergoing laparoscopic radical resection of colon cancer.

Objective:To observe the pregnancy outcomes of patients with unexplained recurrent spontaneous abortion (URSA) after interventional treatment or expectant treatment.Methods:This prospective study followed up 398 patients with recurrent spontaneous abortion from March 2017 to September 2022 in seven hospitals. Among them, 267 patients were diagnosed with URSA, including 124 patients who were initially diagnosed in the interventional treatment hospital and 143 patients who were initially diagnosed in the expectant treatment hospital. All URSA patients were followed up for 33 months. Ongoing pregnancy rates were observed as main outcome indicators.Results:A total of 127 patients became pregnant, and 107 of them had sustained pregnancies, the ongoing pregnancy rate was 84.25% (107/127). The ongoing pregnancy rate was 86.11% (31/36) in the interventional treatment group and 83.52% (76/91) in the expectant treatment group, with no significant difference ( P>0.05). During the follow-up, the ongoing pregnancy rates in the interventional treatment hospital and the expectant treatment hospital were 75.71% (53/70) and 94.74% (54/57), respectively, with a significant difference ( P<0.05). The ongoing pregnancy rate after interventional treatment in the interventional treatment hospital was 82.76% (24/29), which was similar to the 94.00% (47/50) after expectant treatment in the expectant treatment hospital ( P>0.05). Conclusion:The ongoing pregnancy rate of interventional treatment for URSA patients has not been significantly improved, suggesting that it may not be necessary to carry out this treatment.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective:To analyze the epidemiological characteristics and delay in detection of reported brucellosis cases in Nangang District of Harbin City, Heilongjiang Province, in order to provide a basis for improving targeted measures for brucellosis prevention and control.Methods:Data on brucellosis reported in Nangang District of Harbin City between 2018 and 2022 were obtained from the China Disease Prevention and Control Information System. A descriptive analysis was conducted to outline the epidemiological status, epidemiological features, and sources of cases. Seasonal patterns of brucellosis were assessed using the concentration degree and seasonal index methods. Joinpoint regression model was used to analyze the trend of delay in detection.Results:From 2018 to 2022, a total of 4 428 cases of brucellosis were reported in Nangang District, with 1 183 cases (26.72%) reported in 2018 and 528 cases (11.92%) reported in 2022. The gender ratio of the cases was 2.80 ∶ 1.00 (3 264 ∶ 1 164). Most cases occurred in individuals aged 30 to 59 years (73.19%, 3 241/4 428). Occupationally, farmers comprised the majority of cases (88.73%, 3 929/4 428), followed by homemakers/unemployed individuals (3.73%, 165/4 428), and students (2.03%, 90/4 428). Regarding case origin, 31.48% (1 394/4 428) were from Harbin City, while 64.97% (2 877/4 428) originated from other cities within Heilongjiang Province, predominantly from Suihua City (38.89%, 1 722/4 428). Additionally, 157 cases (3.55%, 157/4 428) were reported from outside Heilongjiang Province, all of which were from Inner Mongolia Autonomous Region and Jilin Province. Brucellosis incidence showed weak seasonality ( M = 0.230), with the epidemic period spanning from March to August. During this period, seasonal indices C exceeded 100%, peaking in July (168.02%). From 2018 to 2022, the average annual delay rate in case detection was 20.14% (892/4 428). The delayed detection rates of brucellosis cases in each year were 30.68% (363/1 183), 17.86% (200/1 120), 17.23% (117/679), 12.75% (117/918), and 17.99% (95/528), respectively (average annual percentage change = - 17.52%, P = 0.090). Conclusions:Brucellosis in Nangang District of Harbin Citydemonstrates weak seasonality, with peak incidence occurring from March to August. Detection delays remain a concern, highlighting the need for sustained surveillance and the implementation of integrated, multi-sectoral prevention and control measures.

Objective:To investigate the predictive value of inflammatory and nutritional indices for postoperative survival of elderly patients with esophageal squamous carcinoma.Methods:The retrospective cohort study was conducted. The clinicopathological data of 130 elderly patients with esophageal squamous carcinoma who were admitted to Sichuan Cancer Hospital from January 2019 to April 2020 were collected. There were 102 males and 28 females, aged (70±4)years. Mea-surement data with normal distribution were represented as Mean± SD. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(range). Count data were expressed as absolute numbers, and comparison between groups was conducted using the chi-square test. Receiver opera-ting characteristic (ROC) curves were plotted. The area under the curve (AUC) and optimal cut-off values were calculated. The Kaplan-Meier method was used to plot survival curves, and the Log-rank test was used for survival analysis. The COX proportional hazard regression model was used for univariate and multivariate analyses. Results:(1) Postoperative survival of elderly patients with esophageal squamous carcinoma predicted by inflammatory and multitional indices. Results of ROC curves analysis showed that the best cut-off values of preoperative systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and prognostic nutrition index (PNI) for predicting postoperative survival of elderly patients with esophageal squamous carcinoma were 470.71×10 9/L, 1.11, 2.07, 136.24, and 46.28, respectively. (2) Risk factors analysis of postoperative survival of elderly patients with esophageal squamous carcinoma. Results of multivariate analysis showed that preoperative SII ≥470.71×10 9/L, preoperative SIRI ≥1.11, preoperative PNI<46.28, score of preoperative patient-generated subjective global assessment (PG-SGA) ≥4, postoperative pathological stage Ⅳ and post-operative complications were independent risk factors for the overall survival time of elderly patients with esophageal squamous carcinoma ( hazard ratio=3.30, 2.50, 0.36, 4.86, 1.57, 1.97, 95% confidence interval as 1.10?9.88, 1.07?5.88, 0.16?0.81, 1.13?20.87, 1.20?2.06, 1.02?3.82, P<0.05). (3) Follow-up. All the 130 patients were followed up for 39(range, 1?60)months. Of the 130 patients, 81 cases survived, 49 cases died, and the median overall survival time was not reached. The 1- and 3-year survival rates of the 130 patients were 83.85% and 54.62%, respectively. ① The median overall survival time was 25(0,43)months for patients with SII ≥470.71×10 9/L, and unreached for patients with SII <470.71×10 9/L, showing a significant difference between them ( χ2=60.59, P<0.05). ② The median overall survival time was 26(0,44)months for patients with SIRI ≥1.11, and unreached for patients with SIRI <1.11, showing a significant difference between them ( χ2=45.57, P<0.05). ③ The median overall survival time was unreached for patients with PNI ≥46.28, and 38(0,47)months for patients with PNI <46.28, showing a significant difference between them ( χ2=12.53, P<0.05). ④ The median overall survival time was unreached for patients with PG-SGA <4 and ≥4, showing a signifi-cant difference between them ( χ2=14.41, P<0.05). ⑤ The median overall survival time was 25(1,47)months for patients in pathological stage Ⅲ, 12(1,32)months for patients in stage Ⅳ, and unreached for patients in stage 0, Ⅰ, Ⅱ, respectively, showing a significant difference among them ( χ2=58.75, P<0.05). ⑥ The median overall survival time was 33(1,47)months for patients with postoperative complication, and unreached for patients without postoperative complication, showing a significant difference between them ( χ2=14.27, P<0.05). Conclusions:Preoperative SII, SIRI and PNI have good predictive value for postoperative survival in elderly patients with esophageal squamous carcinoma. Preoperative SII ≥470.71×10 9/L, preoperative SIRI ≥1.11, preoperative PNI <46.28, score of preoperative PG-SGA ≥4, postoperative pathological stage Ⅳ, and postoperative complications are independent risk factors for the overall survival time of elderly patients with esophageal squamous carcinoma. Patients with preoperative SII <470.71×10 9/L, preoperative SIRI <1.11, preoperative PNI >46.28, score of preoperative PG-SGA <4, postoperative pathological stage 0, Ⅰ, Ⅱ, and non post-operative complications have better survival.

Objective:To retrieve and summarize the evidence for postoperative observation time and bed rest time in patients undergoing percutaneous renal biopsy, so as to provide evidence-based basis for postoperative nursing of patients undergoing percutaneous renal biopsy.Methods:Using search terms such as "renal biopsy" and "renal puncture", based on the "6S" evidence resource pyramid model, evidence on postoperative observation time and bed rest time of percutaneous renal biopsy patients, including guidelines, best practice information books, evidence summaries, systematic reviews, expert consensus, and original research, was systematically searched on various guideline websites, evidence-based databases, original research databases, and professional association websites both domestically and internationally. The search period was from database establishment to July 1, 2023. After independent evaluation of the included literature by two researchers, evidence was extracted and summarized from the literature that met the quality standards.Results:A total of nine articles were included, including one guideline, five cohort studies, and three cross-sectional studies. This study summarized six best pieces of evidence from two aspects, namely postoperative observation time and postoperative bed rest time. For patients with low risk of complications after percutaneous renal biopsy, it was recommended to observe for 6 to 8 hours after surgery, but further shortening the observation time to 4 to 5 hours may also be safe and sufficient. For patients with high risk of complications after percutaneous renal biopsy, those living far from the hospital, those living alone, or those who may experience significant psychological stress after biopsy, it was recommended to extend the observation time to up to 24 hours.Conclusions:Based on existing evidence, it seems feasible to shorten the bed rest time after percutaneous renal biopsy. A large amount of high-quality research is still needed to explore the optimal postoperative bed rest time.