Objective To understand the changing distribution and antimicrobial resistance profiles of Proteus,Morganella and Providencia in hospitals across China from January 1,2015 to December 31,2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods Antimicrobial susceptibility testing was carried out following the unified CHINET protocol.The results were interpreted in accordance with the breakpoints in the 2021 Clinical & Laboratory Standards Institute(CLSI)M100(31 st Edition).Results A total of 32 433 Enterobacterales strains were isolated during the 7-year period,including 24 160 strains of Proteus,6 704 strains of Morganella,and 1 569 strains of Providencia.The overall number of these Enterobacterales isolates increased significantly over the 7-year period.The top 3 specimen source of these strains were urine,lower respiratory tract specimens,and wound secretions.Proteus,Morganella,and Providencia isolates showed lower resistance rates to amikacin,meropenem,cefoxitin,cefepime,cefoperazone-sulbactam,and piperacillin-tazobactam.For most of the antibiotics tested,less than 10％of the Proteus and Morganella strains were resistant,while less than 20％of the Providencia strains were resistant.The prevalence of carbapenem-resistant Enterobacterales(CRE)was 1.4％in Proteus isolates,1.9％in Morganella isolates,and 15.6％in Providencia isolates.Conclusions The overall number of clinical isolates of Proteus,Morganella and Providencia increased significantly in the 7-year period from 2015 to 2021.The prevalence of CRE strains also increased.More attention should be paid to antimicrobial resistance surveillance and rational antibiotic use so as to prevent the emergence and increase of antimicrobial resistance.

Objective:To establish an ultrasound radiomics model by integrating clinical, pathological, and conventional ultrasound features with radiomics characteristics, and to explore its clinical value in predicting endocrine resistance in hormone receptor(HR)-positive breast cancer.Methods:A retrospective analysis was performed on 478 patients with HR-positive breast cancer from January 2017 to December 2021 in the Second Affiliated Hospital of Harbin Medical University, of which 430 were resistant and 48 were sensitive. The clinical, pathological and immunohistochemical data and ultrasound images were collected.Firstly, the propensity score was used to process and match the data. Secondly, Logistic regression was used to screen clinical, pathological, and conventional ultrasound features associated with endocrine resistance. Then, PyRadiomics was used to extract the radiomic features of grayscale ultrasound images, and a series of methods such as Lasso regression were used to screen the radiomic features related to endocrine resistance. Seven machine learning methods such as random forest were used to build a radiomics model. Finally, clinical, pathological and ultrasound features were added to establish a clinical pathological model, a clinical pathological ultrasound model, a clinical pathological radiomics model and a combined model of the four features, and the model effectiveness was evaluated.Results:①Propensity score matching: 96 patients were matched, including 48 patients in the drug-resistant group and 48 patients in the sensitive group. ②Screening clinical pathological conventional ultrasound features related to endocrine resistance: lymph node metastasis, tumor diameter, posterior echo attenuation, and growth orientation were independent predictors of endocrine resistance (all P<0.05). ③Screening radiomics features related to endocrine resistance: 18 features such as Dependence Entropy. ④Establishing radiomics model: the machine learning model of random forest method (AUC=0.80) performed best. ⑤Radiomics model integrating clinical, pathological and conventional ultrasound features: the AUC of the clinical pathological model was 0.70, the AUC of the clinical pathological ultrasound model was 0.78, the AUC of the clinical pathological radiomics model was 0.82, and the AUC of the combined model was 0.86. Conclusions:The radiomics model established by the random forest method performs best in predicting endocrine resistance in HR-positive breast cancer. The model that integrates multiple features performs best in assessing endocrine resistance.which is expected to provide an objective basis for clinicians to predict endocrine resistance in HR-positive breast cancer.

Objective:To investigate the predictive value of thyroid peroxidase antibody(TPOAb), thyroglobulin antibody(TgAb), and thyrotropin receptor antibody(TRAb) status prior to the first 131I treatment in the development of hypothyroidism in patients with Graves′ disease after 131I administration. Methods:The cohort of 89 males and 351 females, with a median age of 34 years (IQR 28-44) who underwent initial 131I therapy at Peking Union Medical College Hospital from December 2019 to December 2021 was established. Participants were classified into TPOAb-positive, TgAb-positive, TRAb-positive, and their respective negative groups based on pre-treatment serum levels of thyroid autoantibody. Sex, age, medical history, thyroid hormone level, thyroid autoantibodies, iodine uptake rate, thyroid estimation and 131I treatment dose were recorded. The 131I treatment dose was determined using the calculated dose method. Patients were followed up for one-year post-treatment to evaluate efficacy. Mann- Whitney U test and χ 2 test were used to compare and analyze the data between groups, and logistic regression was used to analyze the influencing factors of permanent hypothyroidism after treatment. Results:(1) In the TPOAb-positive group, transient hypothyroidism and permanent hypothyroidism occurred in 8.1%(26/321) and 44.9%(144/321), both of which were significantly higher than those in the TPOAb-negative group at 2.5%(3/119) and 31.9%(38/119); In the TRAb-negative group, permanent hypothyroidism occurred in 56.8%(25/44), which was significantly higher than that in the TRAb-positive group 39.5%(152/385). (2) After the first 131I treatment, males ( OR=0.518, 95% CI 0.314-0.855, P=0.010), TPOAb-positive ( OR=1.002, 95% CI 1.001-1.003, P=0.001), and TRAb-negative( OR=0.973, 95% CI 0.957-0.990, P=0.002) were independent influence factor, of permanent hypothyroidism. Conclusion:In the calculated dose method for treating GD, male, TPOAb-positivity, and TRAb-negativity prior to initial 131I treatment are associated with a higher likelihood of developing permanent hypothyroidism post-treatment.

Objective:To deeply understand the evaluation of allergic rhinitis patients on the use of health education accurately linking system, analyze their real experience and needs, so as to provide improvement basis for optimizing intelligent mobile education system.Methods:From January to June 2021, 15 patients with allergic rhinitis were selected from the Otolaryngology and Head and Neck Surgery of Beijing Tongren Hospital affiliated to Capital Medical University by purposive sampling as the interviewee. A total of 15 patients with allergic rhinitis were interviewed semi structurally, and the results were analyzed by thematic analysis.Results:The experience of the health education accurately linking system was refined into three themes, namely, the practicality of the health education content, the effectiveness of the health education form, and the shortcomings of the education content and form.Conclusions:Through the health education accurately linking system as the carrier, the system presents standardized health education knowledge as the core of clinical application interviews. It is necessary to increase access to health information. The content of propaganda and education can mainly be short videos. The disease knowledge module can be improved according to the severity of the disease, so as to improve the quality of health education and promote the occurrence of health behaviors.

Objective:To understand the current status of subjective symptoms and self-management efficacy in patients with chronic rhinosinusitis and nasal polyps after endoscopic sinus surgery, and analyze the correlation between the two.Methods:This study was a cross-sectional study. From July 2018 to June 2020, a total of 228 patients with chronic rhinosinusitis and nasal polyps who underwent endoscopic sinus surgery in a ClassⅢ Grade A hospital in Beijing were selected as the research object. The survey was conducted using the General Information Questionnaire, Visual Analogue Scale (VAS) , and Chronic Disease Self-Efficacy Scale (CDSES) . Pearson correlation and Spearman rank correlation were used for the correlation analysis.Results:Among 228 patients with chronic rhinosinusitis and nasal polyps, there were still 184 cases (80.70%) of nasal congestion, 134 cases (58.77%) of runny nose, 116 cases (50.88%) of olfactory symptoms, 112 cases (49.12%) of head and face pain symptoms, and 208 cases (91.22%) of general discomfort. Among 228 patients with chronic rhinosinusitis and nasal polyps, the symptom management self-efficacy dimension in CDSES score was (6.19±1.04) , and the disease common management self-efficacy dimension score was (7.42±0.95) , and there were 32 cases with a total score of ≥7, accounting for 14.04% (32/228) . The VAS score of various subjective symptoms was negatively correlated with the total score of CDSES and the score of each dimension, and the difference was statistically significant ( P<0.05) . Conclusions:Patients with chronic rhinosinusitis and nasal polyps still have disease symptoms after endoscopic sinus surgery, and the self-management efficacy needs to be further strengthened. Clinical nurses should pay attention to subjective symptoms of these patients after surgery, teach them how to manage disease symptoms, and improve the patient's self-management efficacy.

Objective To investigate the effects of Maiqi-Jiangtang pill on the glycolipid level in type 2 diabetic ob/ob mice.Methods The 8-week old male ob/ob mice were randomly divided into Maiqi-Jiangtang pill high- (8 g/kg), medium- (4 g/kg), low- (2 g/kg) dose groups. All the mice orally adiministered with the drugs once a day for 10 weeks. The same week age normal C57BL/6J control mice and ob/ob model group mice were orally administered with the equal volume solvent. The body weight per week were recorded. The fasting blood-glucose (FBG) was measured by glycemic instrument. The content of TG, TC, HDL-C, LDL-C in serum, and TG and TC content in liver were determined by biochemical method. The liver index was calculated.Results Compared with ob/ob model group, there was no significant change in body weight of mice administered with Maiqi-Jiangtang pill for 10 weeks. Compared with the model group, the low-, medium- dose Maiqi-Jiangtang pill could significantly decrease the FBG (7.43 ± 1.71 mmol/L,7.84 ± 1.09 mmol/L vs.8.95 ± 0.96mmol/L), the high- dose Maiqi-Jiangtang pill could significantly reduce the TG (0.93 ± 0.16 mmol/L vs.1.18 ± 0.26 mmol/L) and LDL-C (2.10 ± 0.51 mmol/L vs.2.56 ± 0.44 mmol/L) content in serum of ob/ob mice (P<0.05), increase the HDL-C/LDL-C ratio (2.40 ± 0.39vs.1.96 ± 0.24) in serum (P<0.01), decrease the liver weight (3.52 ± 0.26 gvs. 3.98 ± 0.35 g) and the liver index (0.063 ± 0.004vs. 0.071 ± 0.006) (P<0.05). Compared with the model group, the low dose Maiqi-Jiangtang pill could also significantly decrease the TG level (0.63 ± 0.25 mmol/gvs. 1.05 ± 0.67 mmol/g) in liver and significantly increase the HDL-C/LDL-C ratio (2.30 ± 0.44vs. 1.96 ± 0.24) in serum (P<0.05).Conclusions The Maiqi-Jiangtang pill can reduce lipid in serum and liver of ob/ob mice while it can decrease the blood glucose, which need to further study its mechanism.

Objective To prevent the gastrointestinal intolerance in patients after laryngectomy by care bundles, so as to improve the effectiveness of enteral nutrition. Methods A total of 117 cases of laryngectomy patients were divided into control group (n=58) and experimental group (n=59) by random number table method. The patients in the control group were given routine nursing care, while the patients in the experimental group were treated by care bundles. The incidence of gastrointestinal intolerance was compared between the two groups in bloating, vomiting, gastroesophageal reflux, diarrhea and gastric retention. Results The incidences of bloating, vomiting, diarrhea and gastric retention of the experimental group were significantly lower than those of the control group, and the differences were statistically significant (P<0.05). The time of indwelling gastric tube in the experimental group and the control group was (12.35±2.29) days and (14.23±2.16) days respectively, and the difference was statistically significant (t=4.79, P< 0.01). Conclusions Care bundles can effectively prevent the occurrence of gastrointestinal intolerance in patients with indwelling gastric tube after laryngectomy.

Objective To explore the difference in the regulating effect of electroacupuncture on serum insulin (Ins) and fat consumption between male and female simple obesity rat and the possible mechanism of its action.Methods A rat model of simple obesity was made by induction with sodium glutamate. The rats were randomized into model and electroacupuncture groups (male and female), 10 rats each. A normal group of 10 rats (male and female) was established as a control. Points Quchi, Zhongwan, Guanyuan, Housanli, Fenglong and Sanyinjiao were selected in the electroacupuncture group. Stimulation with a low frequency of 2 Hz was provided after needle insertion. The treatment was given once daily for 28 consecutive days. Serum Ins content, and greater omentum, pericardiac and perirenal fat weights were measured in the male and female groups of rats before and after electroacupuncture intervention. The comparisons were made.Results Serum Ins content, and greater omentum, pericardiac and perirenal fat weights were significantly lower in the electroacupuncture male and female groups of rats than in the model male and female groups of rats (P<0.01) and also in the electroacupuncture male group of rats than in the electroacupuncture female group of rats (P<0.05).Conclusions Electroacupuncture has different degrees of weight-reducing effect in both male and female obesity rats. The reducing effect on serum Ins content, and greater omentum, pericardiac and perirenal fat weights is better in male obesity rats.

Purpose To quantitatively evaluate the severity of brain damage in the acute phase of CO poisoning using intravoxel incoherent motion imaging.Materials and Methods MRI scans were performed in 26 patients with CO intoxication of acute stage and 18 healthy controls with matched age and gender.The difference of D value,D* value and f value in different ROIs between the poisoning and the control groups were compared,and the best cut-off values were determined.The correlation between the consciousness state and the D value as well as f value in the vulnerable area of the brain (globus pallidus) was analyzed.Results Compared with control group,the D and F value of the poisoning group were decreased in multiple ROIs,of which statistical significance was observed in the f values in the centrum semiovale,globus pallidus and thalamus,and the D values in the centrum semiovale,lateral ventricle,globus pallidus and corpus callosum splenium (P＜0.05).The best cut-off value,sensitivity and specificity were as follows:fcs=51％,77％,73％;fga=61％,77％,83％;ft=80％,85％,64％;D,=0.69×10-3 mm2/s,85％,83％;Dlv=0.65× 10-3 mm2/s,73％,89％;Dga=0.68× 10-3 mm2/s,62％,83％;Dccs=0.70× 10-3mm2/s,81％,89％.The disturbance of consciousness was positively correlated with decrease of D value and f value (rD=0.828,rf=0.745,P＜0.05).Conclusion The D and f values of intravoxel incoherent motion imaging can quantitatively evaluate the brain damage severity in acute CO poisoning.

Objective To study the clinical efficacy of lidocaine on catheter displacement in peritoneal dialysis.Methods Totally 812 patients who performed intubation in the center of peritoneal dialysis from January 2007 to January 2016 were selected as the research object .Patients from January 2007 to May 2008 were taken as the control group , and others were divided into the experimental group .The incidence of catheter displacement and success rate of the reposition of displaced catheter in patients with different catheter and in two groups with different treatment method were observed and compared .Results In the same group , the incidence of catheter displacement in Tenckhoff straight catheter was obviously higher than swan -neck straight catheter ( P<0.05) .In the cases with same catheter , there were no statistically significant differences in the incidence of catheter displacement between the control group and experimental group ( P>0.05 ) .In the same group , the differences in success rate of reposition were statistically significant between Tenckhoff straight catheter and swan-neck straight catheter ( P<0.05 ) .In the cases with same catheter , the differences were statistically significant between patients with swan-neck straight catheter in two groups ( P<0.05 ) , while there were no statistically significant differences between patients with Tenckhoff straight catheter in two groups (P>0.05). Conclusions Lidocaine could effectively increase the success rate of the reposition of displaced peritoneal dialysis catheter .