Objective To investigate the risk factors for bronchopulmonary dysplasia(BPD)in twin preterm infants with a gestational age of<34 weeks,and to provide a basis for early identification of BPD in twin preterm infants in clinical practice.Methods A retrospective analysis was performed for the twin preterm infants with a gestational age of<34 weeks who were admitted to 22 hospitals nationwide from January 2018 to December 2020.According to their conditions,they were divided into group A(both twins had BPD),group B(only one twin had BPD),and group C(neither twin had BPD).The risk factors for BPD in twin preterm infants were analyzed.Further analysis was conducted on group B to investigate the postnatal risk factors for BPD within twins.Results A total of 904 pairs of twins with a gestational age of<34 weeks were included in this study.The multivariate logistic regression analysis showed that compared with group C,birth weight discordance of>25%between the twins was an independent risk factor for BPD in one of the twins(OR=3.370,95%CI:1.500-7.568,P<0.05),and high gestational age at birth was a protective factor against BPD(P<0.05).The conditional logistic regression analysis of group B showed that small-for-gestational-age(SGA)birth was an independent risk factor for BPD in individual twins(OR=5.017,95%CI:1.040-24.190,P<0.05).Conclusions The development of BPD in twin preterm infants is associated with gestational age,birth weight discordance between the twins,and SGA birth.

Objective To observe the therapeutic efficacy and mechanism of Gushi Zaizao Pills for steroid-induced osteonecrosis of the femoral head(SONFH).Methods Male SD rats were randomly divided into normal group,model group,Xianling Gubao Capsules group and Gushi Zaizao Pills group.Except for the normal group,the rats in all other groups were replicated the SONFH model.After successful modeling,the continuous drug administration was carried out for six weeks.The thymus and spleen of the rats were taken to calculate the immune organ indices,the contents of interleukin 1β(IL-1β)and tumor necrosis factor α(TNF-α)in rat synovial fluid were detected by enzyme-linked immunosorbent assay(ELISA),the percentage of empty lacunae and area ratio of trabecular bone was detected by hematoxylin-eosin(HE)staining,and the femoral head parameters[reduction of bone volume fraction(BV/TV),trabecular number(Tb.N),trabecular thickness(Tb.Th)and trabecular separation(Tb.Sp)]were analyzed by Micro-CT,and bone strength of femoral head was detected by small animal bone strength tester.Results Compared with the normal group,the spleen and thymus indicators were significantly decreased in the model group,the levels of IL-1β and TNF-α in rat synovial fluid were significantly increased,the percentage of empty lacunae was increased,the area ratio of trabecular bone was decreased,the BV/TV,Tb.N and Tb.Th were decreased,the Tb.Sp was increased,the bone strength of femoral head was significantly decreased,the differences being all statistically significant(P＜0.05 or P＜0.01).Compared with the model group,the spleen and thymus indicators were significantly increased in Xianling Gubao Capsules group and Gushi Zaizao Pills group,the levels of IL-1β and TNF-α in rat synovial fluid were decreased,the percentage of empty lacunae was significantly decreased,the area ratio of trabecular bone was significantly increased,the BV/TV,Tb.N and Tb.Th were increased,the Tb.Sp was decreased,and the bone strength of femoral head was significantly increased,the differences being all statistically significant(P＜0.05 or P＜0.01).Conclusion Gushi Zaizao Pills can effectively prevent the further development of SONFH by regulating cellular immunity and reducing the secretion of inflammatory factors,thereby reducing the pathological damage of the femoral head and enhancing the bone strength.

Objective:To investigate the association between baseline hemoglobin level and early neurologic deterioration(END)after intravenous thrombolysis in patients with acute ischemic stroke(AIS).Methods:Data of AIS patients who received intravenous thrombolytic therapy at multiple hospitals across the country between January 2017 and July 2020 were collected from the online database Acute Stroke Patients for Stroke Management Quality Evaluation(CASE-Ⅱ,NCT04487340).Binary logistic regression analysis was used to study the factors affecting the occurrence of END after intravenous thrombolytic therapy,and the correlation between baseline hemoglobin level and END was investigated by limiting cubic spline curve analysis.Results:A total of 8162 patients were included.Patients with END had lower baseline hemoglobin levels(136 and 140 g/L,P<0.01)and higher rates of anemia(24.2%and 16.9%,P<0.01)compared with non-END patients.Binary logistic regression analysis showed that baseline hemoglobin level(OR=0.995,95%CI:0.991-0.999,P<0.05)and anemia(OR=1.238,95%CI:1.055-1.454,P<0.01)were independently correlated with the occurrence of END after intravenous thrombolysis in AIS patients.Restricted cubic spline regression showed that there was a U-shaped relationship between hemoglobin level and the risk of END after intravenous thrombolysis in AIS patients(P<0.01),although this relationship was only significant in male patients(P<0.05)and not in female patients(P>0.05).Conclusion:There is a correlation between baseline hemoglobin level and the risk of END in AIS patients after intravenous thrombolysis,especially in male patients,in whom both lower and higher hemoglobin level may increase the risk of END.

Objective To observe the role of empagliflozin tablets combined with benazepril hydrochloride tablets on clinical efficacy and renal outcomes in treating type 2 diabetic kidney disease(DKD).Methods Patients with type 2 DKD were divided into treatment group and control group by means of the random number table method.The control group was treated with benazepril hydrochloride tablets(10 mg,qd)and the treatment group was treated with empagliflozin tablets on the basis of the control group.The initial dose was 10 mg,qd,adjusted to 25 mg after tolerance,qd.Two groups were treated for 3 months.The clinical efficacy,blood glucose indexes[fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1 c)],renal function indexes[serum creatinine(SCr),glomerular filtration rate(eGFR)],oxidative stress indexes[superoxide dismutase(SOD),malondialdehyde(MDA)],renal outcomes and safety were compared between the two groups before and after treatment.Results In the treatment group,63 cases were enrolled,2 cases were lost,and 61 cases were finally included in the statistical analysis.In the control group,63 cases were enrolled,2 cases were lost,and finally 61 cases were included in the statistical analysis.After treatment,the total effective rates in treatment group and control group were 88.52％(54 cases/61 cases)and 73.77％(45 cases/61 cases),respectively(P＜0.05).After treatment,the peripheral blood FPB levels in treatment group and control group were(5.64±0.58)and(6.31±0.79)mmol·L-1;HbA1c levels were(6.09±0.75)％and(6.94±0.96)％;SCr levels were(111.88±11.45)and(119.41±8.31)μmol·L-1;eGFR values were(64.11±9.04)and(58.92±4.79)mL·min-1·1.73 m-2;SOD levels were(45.72±5.53)and(39.54±3.97)U·mL-1;MDA levels were(26.18±3.22)and(30.31±3.65)nmol·mL-1;the incidence rates of adverse renal outcomes were 6.56％(4 cases/61 cases)and 19.67％(12 cases/61 cases),respectively,with statistical differences(all P＜0.05).The adverse drug reactions in treatment group were mainly urinary tract infection,hypoglycemia and headache,and those in control group were mainly hypotension and headache.The incidence rates of adverse drug reactions were 9.84％(6 cases/61 cases)and 6.56％(4 cases/61 cases),respectively(P＞0.05).Conclusion The clinical efficacy of empagliflozin tablets combined with benazepril hydrochloride tablets in the treatment of type 2 DKD is better,which can reduce the incidence of adverse renal outcomes without increasing adverse drug reactions.

Objective To investigate the distribution and antimicrobial resistance of bacterial isolates from blood samples in the hospitals participating in China Antimicrobial Surveillance Network (CHINET) from 2015 to 2021.Methods Bacterial strains isolated from blood samples were collected from 52 medical centers participating in CHINET from 2015 to 2021 for analysis of bacetrial distribution and antimicrobial resistance.Results A total of 153591 isolates were collected,48.8％ of which were gram-positive bacteria and 51.2％ were gram-negative bacteria.The top five bacterial strains were coagulase negative Staphylococcus (28.2％),Escherichia coli (20.7％),Klebsiella (13.7％),Enterococcus (7.2％),and Staphylococcus aureus (6.6％).Compard to female patients,male patients showed lower proportion of E.coli and higher proportions of other bacterial species in all the bacterial isolaets from blood samples.The proportions of Streptococcus pneumoniae and Salmonella in all the bacterial isolaets from blood samples were higher in children compared to adults.Enterobacterales species showed various resistance rates to antimicrobial agents.Overall,≥58.0％,≥36.8％ and ≥56.8％ of E.coli strains were resistant to cefotaxime,gentamicin and levofloxacin respectively over the 7-year period.However,less than 2.5％ of the E.coli strains were resistant to carbapenems.K.pneumoniae showed higher resistance rates to imipenem and meropenem than other Enterobacterales species.During the 7-year period,the prevalence of imipenem-resistant and meropenem-resistant K.pneumoniae increased from 21.4％ and 19.9％ in 2015 to 25.7％ and 26.6％ in 2021,respectively.However,carbapenems still maintained good antibacterial activity against other Enterobacterales,associaetd with lower resistance rates.In the 7-year period,Acinetobacter baumannii showed a dwonward trend in the resistance rates to imipenem and meropenem,but remained 72.9％ and 73.2％ respectively in 2021.The prevalence of imipenem-resistant and meropenem-resistant P.aeruginosa decreased from 26.7％ and 22.9％ in 2015 to 18.5％ and 14.7％ in 2021,respectively.The prevalence of PRSP was 1.5％ in the isolaets from adults and and 0.8％ in the isolates from children.Less than 3.0％ of the Enterococcus faecium and Enterococcus faecalis strains were resistant to vancomycin,teicolanin,or linezolid.The prevalence of methicillin-resistant S.aureus (MRSA) and coagulase negative Staphylococcus (MRCNS) was 32.1％ and 81.0％,respectively.The prevalence of MRSA was relatively stable,28.5％ in 2015 and 28.0％ in 2021.Conclusions Coagulase negative Staphylococcus,E.coli and K.pneumoniae were the main bacterial species isolated from blood samples in the hospitals participaing in the CHINET from 2015 to 2021.Significant sex and age differences were found in the distribution of bcterial isolates from blood samples.The overall resistance rates of the top bacetrial strains from blood samples to antimicrobial agents showed a downward trend.Ongoing surveillance of antimicrobial resistance for the isolates from blood samples is still essential for prescribing rational antimicrobial therapies and curbing bacterial resistance.

Objective To observe the role of empagliflozin tablets combined with benazepril hydrochloride tablets on clinical efficacy and renal outcomes in treating type 2 diabetic kidney disease(DKD).Methods Patients with type 2 DKD were divided into treatment group and control group by means of the random number table method.The control group was treated with benazepril hydrochloride tablets(10 mg,qd)and the treatment group was treated with empagliflozin tablets on the basis of the control group.The initial dose was 10 mg,qd,adjusted to 25 mg after tolerance,qd.Two groups were treated for 3 months.The clinical efficacy,blood glucose indexes[fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1 c)],renal function indexes[serum creatinine(SCr),glomerular filtration rate(eGFR)],oxidative stress indexes[superoxide dismutase(SOD),malondialdehyde(MDA)],renal outcomes and safety were compared between the two groups before and after treatment.Results In the treatment group,63 cases were enrolled,2 cases were lost,and 61 cases were finally included in the statistical analysis.In the control group,63 cases were enrolled,2 cases were lost,and finally 61 cases were included in the statistical analysis.After treatment,the total effective rates in treatment group and control group were 88.52％(54 cases/61 cases)and 73.77％(45 cases/61 cases),respectively(P＜0.05).After treatment,the peripheral blood FPB levels in treatment group and control group were(5.64±0.58)and(6.31±0.79)mmol·L-1;HbA1c levels were(6.09±0.75)％and(6.94±0.96)％;SCr levels were(111.88±11.45)and(119.41±8.31)μmol·L-1;eGFR values were(64.11±9.04)and(58.92±4.79)mL·min-1·1.73 m-2;SOD levels were(45.72±5.53)and(39.54±3.97)U·mL-1;MDA levels were(26.18±3.22)and(30.31±3.65)nmol·mL-1;the incidence rates of adverse renal outcomes were 6.56％(4 cases/61 cases)and 19.67％(12 cases/61 cases),respectively,with statistical differences(all P＜0.05).The adverse drug reactions in treatment group were mainly urinary tract infection,hypoglycemia and headache,and those in control group were mainly hypotension and headache.The incidence rates of adverse drug reactions were 9.84％(6 cases/61 cases)and 6.56％(4 cases/61 cases),respectively(P＞0.05).Conclusion The clinical efficacy of empagliflozin tablets combined with benazepril hydrochloride tablets in the treatment of type 2 DKD is better,which can reduce the incidence of adverse renal outcomes without increasing adverse drug reactions.

Objective To investigate the distribution and antimicrobial resistance of bacterial isolates from blood samples in the hospitals participating in China Antimicrobial Surveillance Network (CHINET) from 2015 to 2021.Methods Bacterial strains isolated from blood samples were collected from 52 medical centers participating in CHINET from 2015 to 2021 for analysis of bacetrial distribution and antimicrobial resistance.Results A total of 153591 isolates were collected,48.8％ of which were gram-positive bacteria and 51.2％ were gram-negative bacteria.The top five bacterial strains were coagulase negative Staphylococcus (28.2％),Escherichia coli (20.7％),Klebsiella (13.7％),Enterococcus (7.2％),and Staphylococcus aureus (6.6％).Compard to female patients,male patients showed lower proportion of E.coli and higher proportions of other bacterial species in all the bacterial isolaets from blood samples.The proportions of Streptococcus pneumoniae and Salmonella in all the bacterial isolaets from blood samples were higher in children compared to adults.Enterobacterales species showed various resistance rates to antimicrobial agents.Overall,≥58.0％,≥36.8％ and ≥56.8％ of E.coli strains were resistant to cefotaxime,gentamicin and levofloxacin respectively over the 7-year period.However,less than 2.5％ of the E.coli strains were resistant to carbapenems.K.pneumoniae showed higher resistance rates to imipenem and meropenem than other Enterobacterales species.During the 7-year period,the prevalence of imipenem-resistant and meropenem-resistant K.pneumoniae increased from 21.4％ and 19.9％ in 2015 to 25.7％ and 26.6％ in 2021,respectively.However,carbapenems still maintained good antibacterial activity against other Enterobacterales,associaetd with lower resistance rates.In the 7-year period,Acinetobacter baumannii showed a dwonward trend in the resistance rates to imipenem and meropenem,but remained 72.9％ and 73.2％ respectively in 2021.The prevalence of imipenem-resistant and meropenem-resistant P.aeruginosa decreased from 26.7％ and 22.9％ in 2015 to 18.5％ and 14.7％ in 2021,respectively.The prevalence of PRSP was 1.5％ in the isolaets from adults and and 0.8％ in the isolates from children.Less than 3.0％ of the Enterococcus faecium and Enterococcus faecalis strains were resistant to vancomycin,teicolanin,or linezolid.The prevalence of methicillin-resistant S.aureus (MRSA) and coagulase negative Staphylococcus (MRCNS) was 32.1％ and 81.0％,respectively.The prevalence of MRSA was relatively stable,28.5％ in 2015 and 28.0％ in 2021.Conclusions Coagulase negative Staphylococcus,E.coli and K.pneumoniae were the main bacterial species isolated from blood samples in the hospitals participaing in the CHINET from 2015 to 2021.Significant sex and age differences were found in the distribution of bcterial isolates from blood samples.The overall resistance rates of the top bacetrial strains from blood samples to antimicrobial agents showed a downward trend.Ongoing surveillance of antimicrobial resistance for the isolates from blood samples is still essential for prescribing rational antimicrobial therapies and curbing bacterial resistance.

【Objective】 To analyze the basic characteristics of whole blood donors from blood stations before and after the outbreak of COVID-19. 【Methods】 After excluding invalid data, data related to the basic characteristics of whole blood donors collected from 26 blood stations in China during 2018 to 2021 were statistically analyzed, including the trend of total whole blood donors, the number of repeated blood donors, the frequency of blood donation, the average age of donors and the recruitment of first-time blood donors. 【Results】 Affected by the epidemic, 8 out of 14 indicators were with large variations, accounting for 57%. The overall growth rate of total whole blood donors during the epidemic was higher than before the epidemic (P<0.05).The number of repeated blood donors has shown an increased trend, with a higher number during the epidemic than before (P<0.05). The frequency of blood donation was lower during the epidemic than before(P<0.05).Average ages of blood donors and female blood donors fluctuated widely during the epidemic, both higher than those before the epidemic(P<0.05).The donation rate of first-time blood donors <25 years old and ≥25 years old varied widely and irregularly during the epidemic (both P<0.05). The percentage of first-time blood donors fluctuated irregularly during the epidemic, with overall percentage lower than that before the epidemic(P<0.05). 【Conclusion】 Whole blood donors from 26 blood stations increased after the outbreak of COVID-19, and some indicators in certain areas showed significant fluctuations during the epidemic.

Abstract: Objective　To evaluate the potential transmission risk of schistosomiasis in Yunnan Province, and to provide strategic basis for the prevention and control. Methods　Based on the prevalence of schistosomiasis, the social and environmental factors that may lead to the epidemic, 1-3 villages from 3 provincial-level and 15 county-level counties (cities and districts) were selected as the evaluated villages in 2021. The risk of schistosomiasis spread was analyzed comprehensively by consulting, reviewing and collecting routine surveillance data of schistosomiasis in the villages, combined with snail and wild feces survey. The risk level was evaluated for the positive snails, positive wild feces, resident infection, average density of live snails and snail frame occurrence rate. Results　Totally 7 snail counties schistosomiasis transmission was blocked of 18 epidemic counties and the rest were eliminated counties. A total of 152 447 snail frames were investigated and 3 043 frames with snails, 15 895 snails were captured and included 15 727 live snails in the 32 evaluated villages. The total area of snail was 58.87 hm2 and the area of reoccurrence was 34.19 hm2 with snail frame occurrence rate of 2.00% and average density of live snails 0.103 2/0.11 m2, and no positive snails were found by loop-mediated isothermal amplification (LAMP) assay. A total of 1 374 wild feces were collected in 27 evaluated villages of 14 epidemic counties, mainly from cattle, dogs, sheep, equine animals, pigs and so on, all of which were negative. According to the risk assessment of epidemic spread, Yongle Village and Yongsheng Village in Eryuan County, Zhiming Village in Chuxiong City were Ⅱ risk, and the rest were Ⅲ risk. Conclusions　Although the risk of transmission is low in Yunnan Province, the risk of transmission and spread still exists. It is necessary to strengthen the risk monitoring, control of snail and effective management of livestock to prevent the rebound of the epidemic.

Objective To explore the overall level,distribution characteristics,and differences in household fine particulate matter (PM_2.5) pollution caused by fuel burning in urban and rural areas in China. Methods The relevant articles published from 1991 to 2021 were retrieved and included in this study.The data including the average concentration of household PM_2.5 and urban and rural areas were extracted,and the stoves and fuel types were reclassified.The average concentration of PM_2.5 in different areas was calculated and analyzed by nonparametric test. Results The average household PM_2.5 concentration in China was (178.81±249.91) μg/m³.The mean household PM_2.5 concentration was higher in rural areas than in urban areas[(206.08±279.40) μg/m³ vs. (110.63±131.16) μg/m³;Z=-5.45,P<0.001] and higher in northern areas than in southern areas[(224.27±301.66) μg/m³ vs.(130.11±140.61) μg/m³;Z=-2.38,P=0.017].The north-south difference in household PM_2.5 concentration was more significant in rural areas than in urban areas[(324.19±367.94) μg/m³ vs.(141.20±151.05) μg/m³,χ²=-5.06,P<0.001].The PM_2.5 pollution level showed differences between urban and rural households using different fuel types (χ²=92.85,P<0.001),stove types (χ²=74.42,P<0.001),and whether they were heating (Z=-4.43,P<0.001).Specifically,rural households mainly used solid fuels (manure,charcoal,coal) and traditional or improved stoves,while urban households mainly used clean fuels (gas) and clean stoves.The PM_2.5 concentrations in heated households were higher than those in non-heated households in both rural and urban areas (Z=-4.43,P<0.001). Conclusions The household PM_2.5 pollution caused by fuel combustion in China remains a high level.The PM_2.5 concentration shows a significant difference between urban and rural households,and the PM_2.5 pollution is more serious in rural households.The difference in the household PM_2.5 concentration between urban and rural areas is more significant in northern China.PM_2.5 pollution in the households using solid fuel,traditional stoves,and heating is serious,and thus targeted measures should be taken to control PM_2.5 pollution in these households.
Humans ; Particulate Matter/analysis* ; Air Pollution, Indoor/analysis* ; Cooking ; Environmental Exposure/analysis* ; China ; Rural Population