Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2022.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of national bloodstream infection Bacterial Resistant Investigation Collaborative System（BRICS）were collected during January 2022 to December 2022. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 software were used to analyze the data.Results:During the study period，9 035 strains of Gram-negative bacteria were collected from 51 hospitals，of which 7 895（87.4%）were Enterobacteriaceae and 1 140（12.6%）were non-fermenting bacteria. The top 5 bacterial species were Escherichia coli（ n=4 510，49.9%）， Klebsiella pneumoniae（ n=2 340，25.9%）， Pseudomonas aeruginosa（ n=534，5.9%）， Acinetobacter baumannii complex（ n=405，4.5%）and Enterobacter cloacae（ n=327，3.6%）. The ESBLs-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus spp. were 47.1%（2 095/4 452），21.0%（427/2 033）and 41.1%（58/141），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（58/4 510）and 13.1%（307/2 340）；62.1%（36/58）and 9.8%（30/307）of CREC and CRKP were resistant to ceftazidime/avibactam combination，respectively. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 59.5%（241/405），while less than 5% of Acinetobacter baumannii complex was resistant to tigecycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 18.4%（98/534）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of main Gram-negative bacteria resistance among different regions，with statistically significant differences in the prevalence of CRKP and CRPA（ χ2=20.489 and 20.252， P<0.001）. The prevalence of CREC，CRKP，CRPA，CRAB，ESBLs-producing Escherichia coli and Klebsiella pneumoniae were higher in provinicial hospitals than those in municipal hospitals（ χ2=11.953，81.183，10.404，5.915，12.415 and 6.459， P<0.01 or <0.05），while the prevalence of CRPA was higher in economically developed regions（per capita GDP ≥ 92 059 Yuan）than that in economically less-developed regions（per capita GDP <92 059 Yuan）（ χ2=6.240， P=0.012）. Conclusions:The proportion of Gram-negative bacteria in bloodstream infections shows an increasing trend，and Escherichia coli is ranked in the top，while the trend of CRKP decreases continuously with time. Decreasing trends are noted in ESBLs-producing Escherichia coli and Klebsiella pneumoniae. Low prevalence of carbapenem resistance in Escherichia coli and high prevalence in CRAB complex have been observed. The composition ratio and antibacterial spectrum of bloodstream infections in different regions of China are slightly different，and the proportion of main drug resistant bacteria in provincial hospitals is higher than those in municipal hospitals.

Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical Gram-positive bacteria isolates from bloodstream infections in China in 2022.Methods:The clinical isolates of Gram-positive bacteria from blood cultures in member hospitals of National Bloodstream Infection Bacterial Resistant Investigation Collaborative System（BRICS）were collected during January 2022 to December 2022. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 software were used to analyze the data.Results:A total of 3 163 strains of Gram-positive pathogens were collected from 51 member units，and the top five bacteria were Staphylococcus aureus（ n=1 147，36.3%），coagulase-negative Staphylococci（ n=928，29.3%）， Enterococcus faecalis（ n=369，11.7%）， Enterococcus faecium（ n=296，9.4%）and alpha-hemolyticus Streptococci（ n=192，6.1%）. The detection rates of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococci（MRCNS）were 26.4%（303/1 147）and 66.7%（619/928），respectively. No glycopeptide and daptomycin-resistant Staphylococci were detected. The sensitivity rates of Staphylococcus aureus to cefpirome，rifampin，compound sulfamethoxazole，linezolid，minocycline and tigecycline were all >95.0%. Enterococcus faecium was more prevalent than Enterococcus faecalis. The resistance rates of Enterococcus faecium to vancomycin and teicoplanin were both 0.5%（2/369），and no vancomycin-resistant Enterococcus faecium was detected. The detection rate of MRSA in southern China was significantly lower than that in other regions（ χ2=14.578， P=0.002），while the detection rate of MRCNS in northern China was significantly higher than that in other regions（ χ2=15.195， P=0.002）. The detection rates of MRSA and MRCNS in provincial hospitals were higher than those in municipal hospitals（ χ2=13.519 and 12.136， P<0.001）. The detection rates of MRSA and MRCNS in economically more advanced regions（per capita GDP≥92 059 Yuan in 2022）were higher than those in economically less advanced regions（per capita GDP<92 059 Yuan）（ χ2=9.969 and 7.606， P=0.002和0.006）. Conclusions:Among the Gram-positive pathogens causing bloodstream infections in China， Staphylococci is the most common while the MRSA incidence decreases continuously with time；the detection rate of Enterococcus faecium exceeds that of Enterococcus faecalis. The overall prevalence of vancomycin-resistant Enterococci is still at a low level. The composition ratio of Gram-positive pathogens and resistant profiles varies slightly across regions of China，with the prevalence of MRSA and MRCNS being more pronounced in provincial hospitals and areas with a per capita GDP≥92 059 yuan.

Objective To investigate the correlation between clinical characteristics of self-limited epilepsy in children with spines in the central temporal region(SeLECTS)and plasma levels of ammonia,25-hydroxyvitamin D[25(OH)D].Methods A total of 90 SeLECTS children admitted to Suzhou Hospital Affiliated to Anhui Medical University from September 2021 to October 2023 were selected as the case group,and 90 healthy children were included in the control group during the same period.The differences in plasma ammonia and serum 25(OH)D levels between the two groups were compared.The correlation between clinical characteristics of SeLECTS and plasma levels of ammonia,25(OH)D was retrospectively analyzed.Results Plasma ammonia concentration in case group was significantly higher than that in control group(P＜0.05).The level of 25(OH)D was significantly lower than that of control group(P＜0.05).There were statistically significant differences in plasma ammonia concentration among patients with different age,duration and frequency of SeLECTS(P＜0.05).There were statistically significant differences in serum 25(OH)D content among children with different age,frequency and season of SeLECTS(P＜0.05).The correlation between onset time,onset age and onset frequency was significant at 0.01 level.The correlation between plasma ammonia concentration and age of onset,time of onset and frequency of onset was significant at 0.05 level.At the same time,the correlation between 25(OH)D content and seizure time,seizure frequency and plasma ammonia concentration was significant at 0.05 level.The age of onset,frequency and duration of attacks were positively correlated with plasma ammonia levels of SeLECTS.Age of onset was positively correlated with 25(OH)D level,and frequency of onset was negatively correlated with 25(OH)D level.Conclusion SeLECTS attacks are significantly correlated with plasma ammonia and serum 25(OH)D levels,and both elevated plasma ammonia levels and decreased 25(OH)D levels increase the risk of SeLECTS attacks.Therefore,detection of plasma ammonia and serum 25(OH)D levels in children can provide evidence for prevention,disease assessment,diagnosis and treatment of SeLECTS.

Objective:To summarize the best evidence for the management of acute kidney injury (AKI) after liver transplantation, so as to provide evidence-based basis for preventing the occurrence of AKI and improving the prognosis of patients after liver transplantation.Methods:Using Population, intervention, professional, outcome, setting and type of evidence (PIPOST) to establish evidence-based questions, all evidence on postoperative AKI in liver transplant patients is systematically searched on UpToDate, British Medical Journal (BMJ) Best Practice, Cochrane Library, National Guideline Clearinghouse, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Joanna Briggs Institute Evidence-Based Health Care Center Database, China Biomedical Literature Database, China National Knowledge Infrastructure, WanFang Data and so on. Article types included clinical guidelines, expert consensus, evidence summary, systematic review, best practice information handbook and randomized controlled trial. The search period was from database establishment to September 30, 2022. The relevant evidence was summarized and evaluated.Results:A total of 11 articles were included, involving one guideline, five expert consensus, three systematic reviews, one randomized controlled trial, and one quasi experimental study. Finally, a total of 16 best pieces of evidence were summarized from four aspects, including incidence, risk factors, renal function protection plan, and impact on prognosis.Conclusions:This study summarizes the evidence of postoperative AKI management in liver transplant patients, which can provide evidence-based basis for clinical healthcare professionals. As the evidence in this study comes from both domestic and foreign sources, personalized and targeted plans should be developed based on the patient's situation when applying evidence, in order to reduce the risk of AKI and improve the patient's quality of life.

The main fundus changes of pathologic myopia (PM) are posterior staphyloma (PS) and myopic maculopathy (MM), which includes myopic atrophy maculopathy (MAM), myopic tractional maculopathy (MTM), myopic neovascular maculopathy (MNM) and so on. The clinical manifestations of PM-related fundus lesions are complex, and the classification of PM has been a research hotspot in recent years. The proposal of each classification shows an increasing understanding of PM, and each classification has its advantages but also imperfections. For MM, it is recommended to refine the MTM classification based on the ATN classification and adjust it according to the internal correlation between MAM and MNM. The rapid development of modern imaging technology will promote the continuous update of the classification, and its further improvement will also help to understand the development process of PM, which has important clinical value in preventing its occurrence and progression.

This study aims to investigate the molecular mechanism of the transcription factor MYB10, which is involved in anthocyanin biosynthesis, in different colors of Ribes L. fruitification. Rapid amplification of cDNA ends (RACE) was used to clone the MYB10 genes from Ribes nigrum L. (RnMYB10), Ribes rubrum L. (RrMYB10), and Ribes album L. (RaMYB10), respectively. Phylogenetic analysis showed that RnMYB10 and RrMYB10 were evolutionarily homologous. Real-time quantitative PCR (RT-qPCR) showed that the expression of MYB10 in the fruits of Ribes nigrum L. was higher than that of Ribes rubrum L. and much higher than that of Ribes album L. The expression of RnMYB10 and RrMYB10 increased at first and then decreased as the fruit diameter increased and the fruit color deepened (the maximum expression level was reached at 75% of the fruit color change), while the expression level of RaMYB10 was very low. Overexpression of RnMYB10 and RrMYB10 in Arabidopsis thaliana resulted in purple petioles and leaves, whereas overexpression of RaMYB10 resulted in no significant color changes. This indicates that MYB10 gene plays an important role in the coloration of Ribes L. fruit.
Anthocyanins ; Cloning, Molecular ; Fruit ; Gene Expression Regulation, Plant ; Phylogeny ; Plant Proteins/metabolism* ; Ribes/genetics*

Objective:To understand the current situation of nurses in 52 hospitals in China on mastery of knowledge about skin injury in the elderly based on the background of mixed-mode homogenization training.Methods:Using the convenient sampling method, a total of 1 067 nurses from 52 hospitals in China were selected as the research objects in January 2021. A self-designed questionnaire on knowledge of skin injury in the elderly was used to investigate the nurses through the questionnaire star and univariate analysis was used to analyze the influencing factors. A total of 1 067 questionnaires were distributed and 1 067 valid questionnaires were recovered, and the effective recovery rate was 100%.Results:The knowledge scores of pressure injury, incontinence-associated dermatitis, skin tear and xerosis cutis among 1067 nurses were (95.66±7.37) , (95.65±9.15) , (91.37±15.45) and (87.67±15.91) , respectively. The results of univariate analysis showed that hospital grade was the influencing factor of nurses' knowledge score of pressure injury, skin tear and incontinence-associated dermatitis ( P<0.05) , educational background was the influencing factor of nurses' knowledge score of skin tear ( P<0.05) , professional title was the influencing factor of nurses' knowledge scores of pressure injury, incontinence-associated dermatitis and xerosis cutis ( P<0.05) . Conclusions:Hospitals at all levels need to strengthen the theoretical and practical knowledge training for nurses on skin xerosis and skin tear in the elderly, especially for nurses with primary titles and lower education in grassroots hospitals.

Little is known about the molecular mechanism of currant anthocyanin synthesis. We investigated the effect of dfr, a key gene for anthocyanin synthesis in currant, on anthocyanins of different color currant. Black currant (Ribes nigrum L.), red currant (Ribes rubrum L.) and white currant (Ribes albrum L.) were used as test materials to determine the anthocyanin content at different stages of fruit development. Three full-length cDNA sequences of dfr gene were cloned by RACE (Rapid amplification of cDNA ends), and named as Rndfr, Rrdfr and Radfr. Phylogenetic analysis shows that Rndfr, Rrdfr and Radfr had high homology in evolution. The determination of anthocyanin content in different stages of fruit development shows that the content of anthocyanin in black currant and red currant was higher and gradually increased with the ripening of the fruit. While the content of anthocyanin in white currant was extremely low, and almost no anthocyanin was detected. Quantitative RT-PCR analysis shows that the expression level of dfr in black currant was higher than red currant and white currant in each period of fruit development. As the diameter of the fruit increased and the color of the peel deepened, the expression level of dfr in the black currant showed an increasing trend. In the red currant, the expression level gradually increased until the period of 75% fruit color, then the Rrdfr decreased rapidly. In white currant, the overall trend showed a downward trend, and its expression level was the lowest. All the results suggest that dfr gene plays a role in the process of fruit color.

Objective:To compare effects of two different moisturizing methods on relieving xerostomia in patients undergoing elective abdominal surgery.Methods:A total of 100 patients who underwent elective abdominal surgery in Beijing Friendship Hospital of Capital Medical University from November 2018 to November 2019 were selected and they were divided into the control group (routine gauze inunction) and the observation group (warm water spray) according to the random number table method, with 50 cases in each group. The xerostomia score, moist condition of mucosa of lips, tongue and mouth and salivation secretory volume were collected and compared between the two groups at 2, 6, and 10 h after surgery.Results:After the intervention, xerostomia scores of patients of the two groups at different time points were reduced ( P<0.01) . The xerostomia scores of the observation group at 2, 6, and 10 hours after extubation were all lower than those of the control group [ (7.93±1.30) vs. (8.54±1.42) , (7.10±1.09) vs. (8.00±1.31) , (6.78±0.94) vs. (7.29±1.10) ], and the differences were statistically significant ( P<0.05) . After the intervention, moist conditions of mucosa of lips, tongue and mouth of the two groups were increased at different time points ( P<0.01) . The moisturization degrees of mucosa of lips, tongue and mouth of the observation group were higher than those of the control group at 2, 6, and 10 h after surgery [ (2.24±0.60) vs. (1.85±0.58) , (2.71±0.63) vs. (2.40±0.60) , (3.57±0.74) vs. (3.00±0.71) ], and the differences were statistically significant ( P<0.05) . After the intervention, the saliva secretion of patients of the two groups at different time points increased ( P<0.01) . The saliva secretion of the observation group at 6 and 10 h after surgery were higher than those of the control group [ (3.40±0.57) vs. (3.16±0.55) g, (3.96±0.64) vs. (3.58±0.60) g], and the differences were all statistically significant ( P<0.05) . Conclusions:Compared with the traditional gauze inunction method, the use of warm water spray can more effectively reduce the xerostomia degree of patients undergoing elective abdominal surgery, improve the moisturization of mucosa of lips, tongue and mouth, stimulate saliva secretion and improve xerostomia and oral discomfort of patients undergoing elective surgery with perioperative fasting.

Objective: To evaluate the occupational health risk of decorative coating manufacturing enterprises and to explore the applicability of occupational hazard risk index model in the health risk assessment, so as to provide basis for the health management of enterprises. Methods: A decorative coating manufacturing enterprise in Hebei Province was chosen as research object, following the types of occupational hazards and contact patterns, the occupational hazard risk index model was used to evaluate occupational health risk factors of occupational hazards in the key positions of the decorative coating manufacturing enterprise, and measured with workplace test results and occupational health examination. Results: The positions of oily painters, water-borne painters, filling workers and packers who contacted noise were moderate harm. And positions of color workers who contacted chromic acid salts, oily painters who contacted butyl acetate were mild harm. Other positions were harmless. The abnormal rate of contacting noise in physical examination results was 6.25%, and the abnormality was not checked by other risk factors. Conclusion The occupational hazard risk index model can be used in the occupational health risk assessment of decorative coating manufacturing enterprises, and noise was the key harzard among occupational harzards in this enterprise.