ObjectiveTo explore the effectiveness of health information dissemination and its influencing factors using the "Shanghai CDC" WeChat public account as a case study, providing references for public health institutions to optimize the use of official new media platforms for effective publicity. MethodsA total of 1 030 headline articles published on the "Shanghai CDC" WeChat public account between 2016 and 2019 were analyzed using content analysis and non-parametric tests to examine the impact of factors such as titles and content categories. ResultsFrom 2016 to 2019, the number of WeChat public account followers increased by 280 000, with the articles accumulating over 8.8 million views. The median (P₂₅, P₇₅) open rate of articles was 5.90% (3.69%, 10.31%), and the median (P₂₅, P₇₅) sharing and forwarding rate was 6.60% (4.25%, 9.17%). Factors such as the use of first- and second-person pronouns, degree adverbs, negative adverbs, explicit viewpoints, and title length all significantly affected the open rate of articles, with OR (95%CI) values of 0.175 (0.041‒0.756), 32.606 (2.350‒452.432), 4.079 (1.093‒15.230), 0.106 (0.028‒0.409), and 1.184 (1.063‒1.319),respectively (all P<0.05). In terms of content, statistical significant differences in dissemination effectiveness were observed across article categories and themes (P<0.05). In terms of article categories, articles related to news hotspots and service information had higher open rates of 9.58% and 14.00%, respectively. These two types of articles also obtained higher sharing and forwarding rates of 7.65% and 9.16%, respectively. In terms of article topics, compared with healthy life and health products, among the top four topics in terms of publication volume, the open rates of articles about infectious diseases and disease-causing biology and immunization programs were higher, accounting for 7.88% and 6.88%, respectively, with no significant difference in sharing and forwarding rates. ConclusionThe "Shanghai CDC" WeChat public account demonstrated good dissemination effectiveness. Enhancing article titles by increasing informational content and degree adverbs (e.g., "highly," "most," and "extremely") and negative adverbs (e.g., "no") can improve dissemination reach. Public health WeChat accounts should incorporate news hotspots or service information in their articles. While maintaining their strengths in disseminating knowledge on infectious diseases and immunization programs, they should also enhance public education in other professional fields within their scope of responsibility to improve the overall dissemination impact of health information.

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 analyze the genetic mutation characteristics of glucose-6-phosphate dehydrogenase (G6PD) deficiency among infants in Kunming.Methods:A total of 15 533 infants (7 994 males and 7 539 females) born in Kunming from January 1, 2018, to December 31, 2020, with an age range of 2 to 44 days, were selected. G6PD enzyme activity and gene mutation types were detected using fluorescence quantitative analysis, multicolor melting curve analysis (MMCA), and Sanger sequencing. Droplet digital PCR (ddPCR) was used for quantitative analysis of a newly identified variant family to determine the mutant allele proportion in family members. Meanwhile,the protein structure model and pathogenicity prediction of the novel variant were analyzed.Data analysis was conducted using SPSS 26.0. Specifically, chi-square tests were used for the detection rates of G6PD enzyme activity and gene mutations between different genders. One-way analysis of variance (ANOVA) was used for the comparison of enzyme activity among different mutation types.Results:Among 15 533 infants, 143 cases (129 males and 14 females) were tested positive for G6PD activity, with a detection rate of 0.92% (143/15 533). The difference in detection rates between males and females was statistically significant (χ 2=96.76, P<0.001). Out of 89 enzyme activity-positive cases (83 males and 6 females) underwent genetic testing, 77 (72 males and 5 females) were detected by MMCAand other 12 negative samples were underwent further Sanger sequencing, revealing mutations in 6 samples, all of which were males. Among the 83 individuals with gene mutations, 78 had heterozygous mutations, 1 had a homozygous mutation, and 4 had compound heterozygous mutations. A total of 12 mutation types were detected, with G6PD c.487G>A, c.1024C>T, c.1388G>A, and c.1376G>T being the most common, accounting for 74.70% (62/83) of all mutation types. The average G6PD enzyme activity of c.1376G>T was the lowest, and the differences were statistically significant compared to the average enzyme activity of the other three mutations ( P<0.05). One male infant with a newly identified G6PD c.242G>C mutation was detected, predicted to be pathogenic. ddPCR confirmed that the mother of the affected child was a c.242G>C mutant chimera, with a chimera proportion of 6.66%. Conclusions:In the Kunming region, the predominant G6PD deficiency gene mutation is c.487G>A, with the detection of a novel G6PD c.242G>C mutation. The application of ddPCR technology can assist in detecting the proportion of mutation chimeras.

Objective To investigate the expression of long non-coding RNA(LncRNA)PICSAR in ovarian canc-er,and explore the effects of LncRNA PICSAR on the proliferation,migration,invasion and apoptosis of ovarian cancer cells as well as its possible mechanism of action.Methods The expression levels of LncRNA PICSAR in o-varian cancer tissue and cell line A2780,OVCAR-3,HO-8910 and normal ovarian tissue and cell line IOSE386 were detected by fluorescence quantitative PCR.Ovarian cancer cell lines with the highest expression of LncRNA PICSAR were divided into control group and experimental group,and transfected with negative control small inter-fering RNA(siRNA-NC)or PICSAR knockout small interfering RNA(siRNA-PICSAR)by liposome transfection technique,respectively.The effects of LncRNA PICSAR knockdown on the invasion,migration,proliferation and apoptosis of ovarian cancer cells were analyzed by cell counting assay(CCK-8),clonogenic assay,scratch assay,transwell assay and flow cytometry and so on.The expression levels of autophagy related proteins and apoptosis-re-lated proteins in each group were determined by Western blot.Ovarian cancer cells were treated with rapamycin and hydroxychloroquine as autophagy activator and inhibitor,and Western blot assay was used to detect apoptosis.Results The expression level of LncRNA PICSAR in ovarian cancer tissues was higher than that in normal ovarian tissues.Compared with IOSE386 cell line,LncRNA PICSAR expression levels in ovarian cancer cell lines HO-8910,OVCAR-3 and A2780 increased.Compared with the si-NC group,the proliferation,invasion and migration ability of ovarian cancer cells in si-PICSAR group decreased,and the apoptosis rate increased.The autophagy level of ovarian cancer cells in si-PICSAR group was lower than that in si-NC group.After transfection with siRNA-PIC-SAR,rapamycin activated autophagy to reduce apoptosis,while hydroxychloroquine inhibited autophagy to promote apoptosis.Conclusion LncRNA PICSAR is highly expressed in ovarian cancer tissues and cell lines,and the ma-lignant biological behavior of ovarian cancer cells can be inhibited by knockout of LncRNA PICSAR.The knock-down of LncRNA PICSAR may promote the apoptosis of ovarian cancer cells by regulating autophagy.

The Mongolian gerbil currently used as laboratory animals worldwide all originates from China.As early as the 1930s,wild Mongolian gerbils were domesticated and introduced into medical research.Today,they have become recognized multifunctional laboratory animals and are extensively used in various fields such as brain nerve studies,parasitology and microbiology,and oncology,etc.Mongolian gerbils possess unique anatomical characteristics in the basal cerebral arteries,such as a congenital absence of the Willis'circle,making it possible to construct cerebral ischemia or cerebral ischemia-reperfusion injury models with simple procedures of unilateral common carotid artery ligation,while also enabling intra-individual control.These anatomical features also increase their sensitivity to cerebral ischemia and make them more prone to cochlear ischemia,therefore playing a crucial role in the preparation of auditory impairment models.The disease progression and pathological manifestations in Mongolian gerbils show many similarities to those observed in human patients.Researchers have successfully used Mongolian gerbils to develop models of cerebral ischemia,cerebral ischemia-reperfusion,cochlear ischemia,cochlear implantation,and sensorineural hearing loss,achieving significant results.This article focuses on the current methods and assessment indicators for constructing Mongolian gerbils models of cerebral ischemia and auditory impairment.It discusses the advantages and disadvantages of various modelling techniques,and explores their application progress,aiming to provide a theoretical basis and reference for the application of Mongolian gerbils in these two important research areas.

Objective To investigate the expression level,diagnostic value and correlation of miR-497-5p and human fibroblast growth factor-2(FGF-2)in patients with Alzheimer's disease(AD).Methods The clinical data of 50 patients with first diagnosed AD and 37 normal subjects(control group)were collected,among which AD patients were divided into mild AD group(n=18),moder-ate AD group(n=18)and severe AD group(n=14).The expression level of miR-497-5p was detected by real-time quantitative polymerase chain reaction(RT-qPCR)and FGF-2 was detected by enzyme-linked immunosorbent assay(ELISA).Mini-mental state examination(MMSE)was used to evaluate the cognitive function of AD patients,and the correlation between miR-497-5p and MMSE and FGF-2 levels was analyzed.The diagnostic efficacy of miR-497-5p and FGF-2 levels for AD was evaluated using receiv-er operator characteristic(ROC)curve.Results Compared with the control group and mild AD group,the expression levels of miR-497-5p in moderate and severe AD groups were significantly increased(P＜0.01),and the level of FGF-2 was significantly decreased(P＜0.01).MiR-497-5p in AD group was negatively correlated with MMSE score and FGF-2 level(r were-0.724 and-0.748,P＜0.01).ROC curve analysis results showed that miR-497-5p,FGF-2 and their combined indexes had higher area under the curve,sensitivity and specificity in the diagnosis of moderate and severe AD and in the differentiation of mild and moderate AD,as well as mild and severe AD,and the combined indexes of miR-497-5p and FGF-2had the best diagnostic and differential efficacy.Conclusion Serum miR-497-5p is up-regulated and FGF-2 level is down-regulated in patients with moderate and severe AD.The combined detection of miR-497-5P and FGF-2has certain diagnostic value for moderate and severe AD and provides certain reference.

Objective To investigate clinicians'practice and opinions on sedation therapy in end-stage patients at Peking Union Medical College Hospital.Methods From August,2022 to April,2023,an online questionnaire survey was conducted among clinicians involved in end-stage patient management.Results A total of 205 questionnaires were distributed,with an effective response rate of 56.1% .Among the clinicians,55.7% of them had experience of applying sedation therapy in end-stage patients;85.2% of clinicians believed that se-dation could relieve the suffering of terminal patients from physical refractory symptoms;75.7% of clinicians considered that sedation therapy could be used to relieve agony from psycho-existential distress.Most clinicians had concerns about sedation therapy due to the lack of legal support(86.1% )and the lack of understanding of patients or families(59.1% ).The majority(90.4% )of clinicians were willing to receive training on palliative sedation.Conclusions A majority of clinicians agree that sedation therapy could relieve the physical distress and psycho-existential distress in end-stage patients.However,most clinicians have concerns about the application of sedation therapy due to the lack of legal support.It is necessary to enhance the training on palliative sedation.

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:This study focuses on the use of narrative medical records in palliative care teams and analyzes text from cases.The goal is to establish a foundation for standardizing and structuring narrative content, providing guidance for incorporating future narratives into medical record writing.Methods:Three cases of narrative medical records from the palliative care team at Peking Union Medical College Hospital were chosen for text analysis to demonstrate the clinical significance of narrative medical records within palliative care teams.These records included medical consultation records, social work service records, and disease progress records, authored by nurses, social workers, and doctors, respectively.Results:Our study discovered that narrative medical records demonstrate traits such as structured writing, cooperative writing, and comprehensive documentation.Furthermore, the narrative information contained in these records can be efficiently organized and condensed.Conclusions:By examining the cases and utilization of narrative medical records in the healthcare community, we emphasize the potential benefits of incorporating narrative elements into existing medical documentation.These results offer valuable insights for enhancing medical education in the future.

OBJECTIVE To explore the new idea of creating pharmaceutical science popularization oriented by internet medication consultation questions， and provide references for pharmacists to create high-quality pharmaceutical science popularization articles. METHODS By taking the internet medication consultation questions from September 1st， 2021 to February 28th， 2022 in a hospital as samples， pharmaceutical science popularization were created by using the Pareto chart for summarizing and analyzing the demands of the public pharmaceutical knowledge. The readers and creating cycle of pharmaceutical science popularization before and after the implementation of this method were compared by statistical analysis. RESULTS According to the Pareto principle， the types of consultation questions were mainly concentrated on usage and dosage， adverse reactions， and precautions； the types of drug consultation were mainly concentrated on respiratory system medications， anti-infective drugs， rheumatic immune system medications， and orthopedic medications， etc. Fifteen topics of science popularization were identified. Among them， 5 were published before 2022 and did not adopt the Pareto chart method， serving as the pre-method and consistent with the target theme group （A group）； 10 were published in 2022 after adopting the Pareto chart method， serving as the post- method group （B group）； 5 articles published before 2022 were selected randomly， without adopting the Pareto chart method and inconsistent with the target theme， serving as the pre-method and inconsistencies with the target theme group （C group）. Compared with the A group and the C group， the creating cycle of pharmaceutical science popularization in the B group was significantly reduced. Compared with the C group， the readers were significantly increased in the A group and the B group. CONCLUSIONS Pareto chart could help pharmacists utilize medication consultation questions to identify the pharmaceutical science popularization needed by the public， which could improve the efficiency and quality of creating pharmaceutical science popularization by pharmacists.