Objective To explore the predictive value of serum soluble osteoclast-associated receptor(sOSCAR)for cardiovascular adverse events after percutaneous coronary intervention(PCI)in patients with acute non-ST segment elevation acute myocardial infarction(NSTEMI).Methods From January 2020 to Jan-uary 2022,124 NSTEMI patients admitted to Weifang People's Hospital who underwent PCI were selected as the NSTEMI group,and another 100 healthy volunteers in the same period were selected as the control group.The NSTEMI patients were classified into 31 cases of poor prognosis and 93 cases of good prognosis group ac-cording to whether major adverse cardiovascular events occurred 1 year after PCI.Multivariate Logistic regres-sion model was constructed to analyze the factors affecting the prognosis of NSTEMI patients after PCI,and receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of sOSCAR level on the prognosis of NSTEMI patients after PCI.Results Compared with the control group,serum angiopoietin-2(Ang-2)levels were increased and sOSCAR levels were decreased in the NSTEMI group(P＜0.05).At 1-year follow-up,the incidence of poor prognosis after PCI in 124 NSTEMI patients was 25.00％(31/124).Multivariate Logistic regression analysis showed that increasing age and Ang-2 were independent risk factors affecting the prognosis after PCI in patients with NSTEMI(P＜0.05),and elevated left ventricular ejection fraction and elevated sOSCAR were independent protective factors(P＜0.05).ROC curve analysis showed that the area under the curve of serum Ang-2 and sOSCAR levels combined to predict the prognosis after PCI in NSTEMI patients was 0.865,which was greater than that of serum Ang-2 and sOSCAR levels alone,which were 0.791 and 0.786(P＜0.05).Conclusion Serum sOSCAR level is decreased in patients with NSTEMI and is closely related to the poor prognosis of patients after PCI.Serum sOSCAR combined with Ang-2 has a high predictive value for the poor prognosis of NSTEMI patients after PCI.

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 summarize the clinical diagnosis and treatment process of breast implant associated-anaplastic large cell lymphoma (BIA-ALCL) in symptomatic patients with textured breast implants in Peking Union Medical College Hospital in order to provide reference for the management of such patients in China.Methods:From January 2019 to September 2021, 23 symptomatic patients with textured breast implants were admitted to the Peking Union Medical College Hospital, aged 29-52 years, with an average of 36.2 years. All patients agreed to remove the prosthesis by surgery, and accepted cytology, flow cytometry, and immunohistochemical examination of the fluid around the implants and capsule tissue before or during the operation to complete the BIA-ALCL screening process.Results:All 23 patients presented with unilateral periprosthetic fluid accumulation, with fluid volume ranging from 20 to 130 ml, of which 7 cases were combined with periprosthetic contracture. No tumor cells were found in the pathological findings of effusion and the capsule tissue, and the BIA-ALCL pathologic screening results (CD 30 and ALK) were all negative. No bleeding, infection, wound dehiscence and other complications occurred after the operation.Conclusions:A personalized clinical process should be developed for symptomatic patients with textured breast implants. Attention should be paid to imaging and pathological examinations.

Abstract Child abuse is a global public health problem, which has emerged as a neglected yet pressing issue in global development. Early and accurate identification of abuse at a lower-age group is of great significance for treatment, which might reduce the risk of re-maltreatment and promote children s physical and mental health development. Therefore, by reviewing the clinical characteristics, risk factors and existing abuse identification and screening tools of child abuse, the study aims at providing basic evidence for the development of child abuse risk identification tools and the establishment of child maltreatment system in China, so as to take timely intervention measures to prevent adverse outcomes or reduce their severity.

BACKGROUND:Early-onset scoliosis is a kind of disease that seriously affects the growth of children’s spine and development of cardiorespiratory function. The treatment of the disease has always been the focus of many clinical researchers.OBJECTIVE:To analyze the therapy for early-onset scoliosis and explore the spinal fusion, spinal non-fusion, conventional growth rod technology and magnetic control ed growth rod technology of early-onset scoliosis. METHODS:We retrieved PubMed, CENTRAL, EMbase, the ISI Web of Knowledge Databases, VIP, CNKI, CBM and Wanfang Database for related studies published from inception of the database to March 2016. The key words were“scoliosis, growing rod, complications”. The included 54 studies were analyzed and discussed. RESULTS AND CONCLUSION:For these children of early-onset scoliosis, we should not only maintain the correction of spine deformities, but also protect the ability of spine growth, keeping the normal cardiopulmonary function. In addition to conventional (non-surgical) treatment, there are surgical treatment (such as spinal fusion and growing rod technique) and magnetical y control ed growing rod, a new technology for the treatment of early-onset scoliosis. A comprehensive understanding of the effect of surgical treatment on the spine growth and cardiopulmonary function of children with early-onset scoliosis wil help to prevent the occurrence of related complications, so as to obtain a better therapeutic effect.

Treatment of calcaneal fractures has always been the focus of many clinical researchers.The goals of traditional surgical treatment are not only to restore the integrity of calcaneal articular surface but also to reconstruct the anatomy of the calcaneus.More importantly,we need to reduce postoperative soft tissue swelling and incidence of postoperative complications.In recent years,scholars have reported satisfactory clinical efficacy and prognosis resulting from a sinus tarsal approach for treatment of calcaneal fractures.This paper reviews the latest research progress concerning the sinus tarsal approach for treatment of calcaneal fractures at home and abroad,intending to provide helpful information for the clinical surgeons.

Objective: To analyze the genome characteristics of an avian influenza A (H9N2) virus isolated from an 11-month-old infant, and to look for possible sources of infection. Methods: Throat swabs were collected from an infant with influenza-like illness in influenza sentinel surveillance hospitals and isolated for influenza viruses using cells. The isolates were identified for influenza virus types and subtypes by the method of hemagglutination assay, hemagglutination inhibition assay and fluorescence PCR. Whole genome sequencing of the isolated virus was carried out. The genome nucleic acid sequences and the deduced amino acid sequences were analyzed by comparing the phylogenetic trees which were constructed by bioinformatics software. Results: A seasonal un-typed influenza virus was isolated from the infant with influenza like illness. With fluorescent PCR method , it was identified as H9N2 subtype of avian influenza virus and the case was confirmed as a human infected with an avian influenza A(H9N2) virus. Epidemiological studies revealed that the case had no clear history of poultry contact and exposure. Blast analysis shows that eight segments of the viral genome are avian origin, and 97.5%-99.8% homology with that of viruses isolated from the live-poultry markets. The virus belongs to G57 genotype, deduced amino acid sequence analysis shows that the virus has typical low pathogenic avian influenza characteristics. Conclusions Although the case does not have a clear history of contact or exposure to poultry, molecular traceability suggests that possible sources of infection may be still from poultry.

Objective To investigate the value of the hippocampal subfield's MRI T2 signal intensity in evaluating the effect of the hydrochloric donepezil for mild cognitive impairment(MCI).Methods 20 MCI patients with hydrochloric donepezil (treatment group) and 20 patients with placebo (control group) were scanned by MRI using FSE-T2 sequence.The margin of hippocampal subfields was outlined manually for each side to measure the MRI T2 signal intensity.The relationship between hippocampal MRI T2 signal intensity and MMSE scores was analyzed in the treatment group.Results Before the treatment, there was no significant difference of the MRI T2 signal intensity between groups.After the treatment, the MRI T2 signal intensity in the bilateral head of the treatment group was significantly decreased compared with the control group(P<0.05).There was an inverse relationship between the MRI T2 signal intensity of the bilateral hippocampal head and MMSE scores in the treatment group(P<0.05).Conclusion The MRI T2 signal intensity in the bilateral hippocampal head could be regarded as a valuable marker in making clinical diagnosis and evaluating the effect of the treatment for MCI in its early stage.

Objective To compare the safety and effectiveness of drug-eluting balloon (DEB) with paclitaxel and drug eluting stent (DES) in treating in-stent restenosis (ISR).Methods The clinical data of a total of 76 patients with ISR,who were admitted to authors' hospital to receive stem implantation during the period from January 2012 to September 2014,were retrospectively analyzed.According to the therapeutic means,the patients were divided into paclitaxel DEB group (n=32) and paclitaxel DES group (n=44).The general clinical information and coronary artery angiography findings were collected.The patients were followed up for one year;the all-cause mortality,cardiac death,myocardial infarction,in-stent thrombosis,target lesion revascularization,target vessel revascularization,and major adverse cardiac events were documented.Results No obvious difference in the general data of patients existed between group DEB and group DES (P＞0.05).The incidences of left anterior descending artery ISR in DEB group and in DES group were 43.75％ and 47.73％ respectively.The ISR target vessel types of the two groups were quite similar (P＞0.05).No statistically significant differences in ISR type,ISR lesion type and characteristics of in-stent restenosis existed between the two groups (P＞0.05).One-year following-up examinations indicated that no statistically significant differences in all-cause mortality,cardiac death,myocardial infarction,in-stent thrombosis,target lesion revascularization,target vessel revascularization,and major adverse cardiac events existed between the two groups (P＞0.05).Further analysis revealed that no significant difference in event-free survival existed between the two groups (P＞0.05).Conclusion For the treatment of ISR,the use of paclitaxel DEB is safe and feasible,its curative effect is not less than DES.

Objective To explore the added value of T2-signal intensity (T2-SI) in discriminating tumor-infiltration from pure vasogenic edema with diffusion tensor imaging (DTI).Methods 55 patients with brain tumors [28 with high-grade glioma (HGG),13 with meningioma,and 14 with metastases] and concurrent peritumoral edema were scanned with DTI.The mean fractional anisotropy (FA),mean diffusivity (MD),longitudinal diffusivity (λ//) and radial diffusivity (λ⊥) in peritumoral edema of different tumors were measured and compared with each other.Results Only the mean FA showed significant difference between edema of HGG and meningioma (P＜0.05).When standardized T2-SI was used as the covariant,FA and λ⊥ showed significant differences among the tumor groups.The adjusted FA in edema of HGG was significantly lower than that of metastases (P＜0.05) and meningioma (P＜ 0.001).The adjusted λ⊥ in edema of HGG was significantly higher than that of meningioma (P＜0.05).Conclusion By controlling the effect of T2-SI,the value of DTI in distinguishing tumor-infiltration from pure vasogenic edema could be improved.