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.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

Objective:To explore the effects of Onodera′s prognostic nutritional index (PNI) on the prognosis of locally advanced oropharyngeal squamous cell carcinoma (LA-OPSCC) after induction chemotherapy followed by sequential chemoradiotherapy.Methods:A retrospective analysis was conducted on the clinical data of 52 LA-OPSCC patients receiving induction chemotherapy followed by sequential chemoradiotherapy in The Affiliated Cancer Hospital of Guizhou Medical University during 2014-2018. The PNI values of all the patients at different treatment phases were statistically analyzed, and the ROC curve was employed to determine the optimal critical value of PNI. The patients in this study were divided into a well-nourished group ( n = 27) and a poorly-nourished group ( n = 25). The Kaplan-Meier method was used for survival analysis. The Cox proportional hazards model was utilized to analyze the relationships between different nutritional status and prognosis. Clinical features and adverse reactions were compared between the two groups. Results:The PNI values decreased significantly after radiotherapy, with an optimal critical value of 42.4. The 5-year overall survival (OS) and progression-free survival (PFS) of the well-nourished group (PNI ≥ 42.4) were 62.6% and 60.9%, respectively, which were significantly higher than those (30.1% and 29.7%) of the poorly-nourished group (PNI < 42.4, χ2 = 11.12, 5.74, P < 0.05). The multivariate analysis showed that PNI was an independent prognostic factor for the OS after radiotherapy ( HR = 2.752, 95% CI: 1.095-6.917, P = 0.031). The LA-OPSCC patients aged over 60 years or those who did not respond to induction chemotherapy accounted for a higher proportion of malnutrition after chemoradiotherapy ( χ2 = 4.89, 5.05, P < 0.05). Conclusions:PNI after radiotherapy can be used as a prognostic factor in the evaluation of LA-OPSCC patients receiving induction chemotherapy followed by sequential chemoradiotherapy. The LA-OPSCC patients aged over 60 years or those who do not respond to induction chemotherapy should receive more nutritional support during the chemoradiotherapy.

OBJECTIVE: Dexmedetomidine (DEX), the most specific α ₂-adrenergic receptor agonist widely used for its sedative and analgesic properties, has been reported to upregulate HIF-1α expression to protect hypoxic and ischemic tissues. However, it is largely unclear whether DEX can also upregulate Hypoxia-inducible factor-1 alpha (HIF-1α) expression and its downstream vascular endothelial growth factor-A (VEGFA) in cancer tissues with oxygen-deficient tumor microenvironment. METHODS: We used SMMC-7721 cells, MHCC97-H cells, and a mouse model of orthotopic hepatic carcinoma to explore the effect of DEX on angiogenesis and vasculogenic mimicry (VM) and its mechanism. Under normoxic (20% O ₂) and hypoxic (1% O ₂) conditions, DEX was used to intervene cells, and yohimbine was used to rescue them. RESULTS: The results showed that DEX promoted angiogenesis and VM in human liver cancer cells within a certain dose range, and the addition of yohimbine inhibited this effect. DEX could activate HIF-1α/VEGFA pathway, which was further verified by silencing HIF-1α. Consistently, in vivo results also showed that DEX can up-regulate HIF-1α/VEGFA expression, and enhance the number of VM channels and microvessel density (MVD). CONCLUSION We believe that HIF-1α/VEGFA might be an important signaling pathway by which DEX promotes angiogenesis and VM formation in human hepatocellular carcinoma, whereas α ₂-adrenergic receptor mediation might be the critical mechanisms.
Animals ; Humans ; Mice ; Adrenergic alpha-2 Receptor Agonists/pharmacology* ; Carcinoma, Hepatocellular ; Cardiovascular Physiological Phenomena ; Dexmedetomidine/pharmacology* ; Hypoxia ; Liver Neoplasms/drug therapy* ; Oxygen ; Tumor Microenvironment ; Vascular Endothelial Growth Factor A/genetics* ; Receptors, Adrenergic, alpha-2/metabolism*

Objective To study the expression of transcription factor miR‐200b and CEA and the correlation between the two transcription factors in the process of occurrence and development of colorectal cancer .Methods Expression miR‐200b and CEA mRNA by real‐time PCR in 60 colon cancer tissues and corresponding normal tissues were detected and the results were compared with the clinical features and pathological characters .The relationship between the mRNA expression of miR‐200b and CEA in 60 colon cancer tissues was determined .Results The expression rate of CEA mRNA was detectable to highly expressed rates in colon cancer tissues than that in matched normal tissues (P<0 .01) ,whereas miR‐200b mRNA in the colon cancer tissues was signifi‐cantly lower than that in the matched normal tissues(P<0 .01) .There was no significant correlation between miR‐200b ,CEA mR‐NA expression and age ,sex ,tumor location(P>0 .05) .Loss expression or down regulation expression of miR‐200b mRNA was de‐tected ,whereas CEA mRNA was detectable to highly expressed in the different histological grade and Dukes stages .The expression of miR‐200b mRNA and CEA mRNA were positively correlated with the histological grade in colon cancer .A significant correlation was found between the expression of miR‐200b mRNA and CEA mRNA (r= -0 .790 ,P<0 .001) .Conclusion Loss or down regu‐lation expression of miR‐200b mRNA ,whereas CEA is detectable to highly expressed in colon cancer .Negative correlation occurred in miR‐200b mRNA and CEA mRNA indicates that miR‐200b and CEA provide the new clues of genetic diagnosis and treatment .

Pullulan is a linear glucosic polysaccharide produced by the polymorphic fungus Aureobasidium Pullulans, which has long been applied for various applications in medical and food industry due to its security, stability and low adhesive ability.At present, the two problems in restricting pullulan industrial production are the low polysaccharide production and melanin secreted which is hard to erase completely, giving the following process some problem.As a starting point, this review article collects and analyzes the progress on the breeding of pullulan high-yield strain without melanin in recent years, in order to find more efficient strains breeding methods, laying a foundation for further breeding of pullulan high-yield strain without melanin.

Animals ; Cell Line ; Cytological Techniques ; methods ; Embryonic Stem Cells ; cytology ; Interleukin Receptor Common gamma Subunit ; genetics ; Male ; Mice ; Mice, Inbred NOD ; Mice, SCID ; Mutation

Objective To study the expression of transcription factor Sp1 and CEA and the correlation between the two tran‐scription factors in colorectal cancer .Methods To detect expression Sp1 and CEA mRNA by Real‐Time PCR in 60 colon cancer tis‐sues and corresponding normal tissues and the results were compared with the clinical features and pathological characters .The re‐lationship between the expression of Sp1 mRNA and CEA mRNA in 60 colon cancer tissues was determined .Results The expres‐sion rates of Sp1 and CEA mRNA was detectable to highly expressed rates in colon cancer tissues than the matched normal tissues (P<0 .01) .There was no significant correlation between Sp1 and CEA mRNA expression in age ,sex ,tumor location(P>0 .05) . Sp1 and CEA mRNA was detectable to highly expressed in the different histological grade and Dukes stages .In addition ,a positive correlation was found between the expression of Sp1 mRNA and CEA mRNA(r=0 .706 ,P<0 .01) ,(0< r<1) .Conclusion Sp1 and CEA was detectable to highly expressed in colon cancer .Positively correlation occurred in Sp1 mRNA and CEA mRNA indica‐ted that Sp1 and CEA provide the new clues of genetic diagnosis and treatment .

Objective To investigate the clinical diagnostic value of serum homocysteine (Hcy) ,serum beta 2-microglobulin(Sβ2-MG),urine beta 2-microglobulin(Uβ2-MG),urine microalbumin(UmAlb) combined detection for diabetic nephropathy (DN). Methods 230 cases of type 2 diabetes in which 100 patients without complications (diabetic group) ,130 patients with DN (DN group) were enrolled ,and another 50 healthy people served as control group .Automatic biochemical analyzer was employed to de-tect serum Hcy and creatinine ,automated chemiluminescence analyzer was used to detect Sβ2-MG and Uβ2-MG ,Glycated hemoglo-bin cytometry was adopted to measure glycosylated hemoglobin A 1c(GHbA1c) .Positive rates were compared among serum Hcy , Sβ2-MG ,Uβ2-MG ,UmAlb detection and sensitivity ,specificity ,accuracy ,positive predictive value and negative predictive value were compared between individual and joint detection .Results Serum Hcy ,GHbA1c ,creatinine ,Sβ2-MG ,Uβ2-MG and UmAlb concen-trations of patients in DN group were significantly higher than those in the diabetic group and the control group (P< 0 .01) . Difference of serum creatinine concentration showed no statistical significance between the diabetic group and the control group (P>0 .05) ,and differences of remaining indicators′concentration in the diabetic group were significantly higher than those in the control group(P<0 .05) .The positive rate of Hcy ,Sβ2-MG ,Uβ2-MG and UmAlb combined detection in the diabetic group was 23 .00% .In DN group ,the positive rate of the four indicators combined detection was 95 .38% ,with 84 .67% ,84 .35% for specificity and posi-tive predictive value ,respectively ,and 95 .38% ,89 .64% ,95 .49% for sensitivity ,accuracy and negative predictive values ,respective-ly .Conclusion Serum Hcy ,Sβ2-MG ,Uβ2-MG and UmAlb combined detection has important value for early diagnosis of DN .

Objective To investigate the relationship between extent of hepatic fibrosis and serum thyroid hormone levels in pa-tients with liver cirrhosis .Methods Chemiluminescence immunoassay technology was adopted to detect serum hyaluronic acid (HA),laminin(LN),collagen type Ⅳ (CIV),procollagen type Ⅲ (PC Ⅲ ),thyroid stimulating hormone(TSH),triiodothyronine (T3) ,thyroxine(T4) ,free thyroxin 3(FT3) and FT4 of 240 patients with liver fibrosis (liver fibrosis group) and 80 healthy people (control group) .Results In the control group ,serum HA ,LN ,CIV ,PCⅢ levels of healthy people in ≥45-year group were signifi-cantly higher than those in <45-year group ,and those in male group were obviously higher than female(P<0 .05) .Serum TSH , T3 ,T4 ,FT3 ,FT4 levels of healthy people in male group were significantly lower than female (P<0 .05) .With the increase of grade in Child-Pugh classification ,serum levels of hepatic fibrosis indexes of patients with liver fibrosis increased markedly (P<0 .05) , while their thyroid hormone levels significantly decreased (P<0 .05) ,especially in T3 and FT3 .Serum HA ,LN ,CIV ,PCⅢ levels of patients with A ,B or C grade were markedly higher than those in control group(P<0 .05) ,and serum T3 ,T4 ,FT3 ,FT4 levels of patients with B or C grade were obviously lower than those in control group (P<0 .05) .Conclusion The extent of liver fibrosis is correlated to serum thyroid hormone levels .