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.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

OBJECTIVE: To investigate the genetic results of whole exome sequencing of bone marrow from new onset multiple myeloma (MM) patients to analyze the process of genetic clonal evolution in MM patients. METHODS: Genomic DNA was extracted from bone marrow samples of 15 MM patients and the whole exomes sequencing was performed using next generation sequencing technology. Using own buccal cells as germline controls, combinated with clinical information, the mutation profile of genes from high-risk asymptomatic myeloma to symptomatic myeloma were analyzed, and genes that may be associated with the efficacy and side effects of bortezomib were screened. RESULTS: Except for two patients in whom no peripheral neuropathy was observed after a short treatment period, other patients peripheral neuropathy developed of various degrees during treatment with bortezomib containing chemotherapy, and the vast majority of patients achieved remission after receiving this bortezomib-related chemotherapy regimen. All patients had comparable levels of the inherited mutations number, but the somatic mutations was correlated with disease evolution. CONCLUSION different gene "mutational spectra" exist in myeloma patients at different stages and are associated with progression through all stages of the disease.
Humans ; Multiple Myeloma/drug therapy* ; Bortezomib/therapeutic use* ; Bone Marrow ; Exome Sequencing ; Mouth Mucosa ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use*

To explore the effect of Internet+diet self-management intervention technology on the blood pressure control of hypertension high-risk population through the intervention of hypertension high-risk population in Haikou City community, so as to provide scientific evidence for the prevention and treatment of cardiovascular diseases (CVD). The multi-stage cluster sampling method was used, and 295 hypertension high-risk participants were recruited from 15 communities in Haikou City from July to December 2021. The 15 communities were randomly divided into three groups: blank group, traditional group and Internet plus group by random number table method. The blank group referred to the group (99 participants) that did not take special intervention measures but the routine interventions in accordance with the "National Basic Public Health Service Standards (the Third Edition) Health Education Service Standards". On the basis of the blank group, the traditional group (95 participants) was intervened by giving additional traditional methods such as holding lectures and distributing popular science books. The Internet plus group (101 participants) was given additional Internet measures on the basis of the intervention of the traditional group. After 6 months, questionnaires, laboratory biochemical tests, and physical measurements were conducted. SPSS 25.0 software was applied for data analysis. Measurement data that followed normal distribution were statistically described by using mean±standard deviation, analysis of variance was used for inter group comparisons before intervention, analysis of covariance was used for inter group comparisons after intervention, and Bonferroni adjustment was used for pairwise comparisons between groups. Measurement data that did not follow the Normal distribution were represented by M (Q₁, Q₃). The rank sum test was used for inter group comparison. The k sample Kruskal Wallis single factor ANOVA was used to compare the distribution between different groups. Counting data were described by composition ratio or rate. Under the premise of balanced comparison between groups before intervention, Chi-squared test was used for inter group comparison after intervention, and Bonferroni adjustment method was used for pairwise comparison between groups. The results showed that a total of 295 participants were included, with males accounting for 35.6% (105) and females accounting for 64.4% (190). The age ranged from 55 to 74 years old, with an average age of (64.69±5.73) years. The number of married accounted for 95.6% (282 participants). There were no statistically significant differences in gender, age, family history, education level, occupation, marital status, drinking habits, regular exercise, dietary status, SBP (systolic blood pressure), DBP (diastolic blood pressure), pulse pressure difference, BMI (body mass index), folic acid, and 24-hour urine sodium among the three groups upon enrollment (P values>0.05). After the intervention, the drinking rate was as follows: Internet plus group (29, 28.7%)2=28.948, P<0.001); Regular exercise rate was higher in the Internet plus group (37, 36.6%) than in the traditional group (18, 18.9%) and the blank group (16, 16.2%) (χ²=13.476, P=0.001). After the intervention, compared with the participants in the blank group, the intake of energy, carbohydrate, dietary fiber, sodium and folic acid in the Internet plus group were significantly different (all P<0.05); Compared with the participants in the traditional group, the energy, carbohydrate and dietary fiber intake of the participants in the Internet plus group were significantly different (all P<0.05). After the intervention, the blood pressure levels in the Internet plus group [ SBP: (128.95±6.55) mmHg, DBP: (79.88±5.75) mmHg ] and the traditional group [ SBP: (129.63±8.41) mmHg, DBP: (79.77±7.73) mmHg ] were lower than those in the blank group [ SBP: (132.93±8.41) mmHg, DBP: (82.42±7.76) mmHg ] (SBP: F=9.417, P<0.001; DBP: F=6.967, P=0.001), the 24-hour urinary sodium level in the Internet plus group (143.63±38.58) mmol/24 h was lower than that in the traditional group (163.31±35.67) mmol/24 h and the blank group (154.14±35.52) mmol/24 h (F=11.509, P<0.001). In conclusion, compared with the traditional intervention mode, the "Internet plus diet self-management intervention" mode is more likely to promote the development of a healthy lifestyle for people at high risk of hypertension, effectively improve blood pressure and 24-hour urine sodium level, and facilitate CVD prevention.
Male ; Female ; Humans ; Middle Aged ; Aged ; Blood Pressure ; Self-Management ; Hypertension/prevention & control* ; Cardiovascular Diseases/prevention & control* ; Diet ; Sodium ; Internet ; Folic Acid

To explore the effect of Internet+diet self-management intervention technology on the blood pressure control of hypertension high-risk population through the intervention of hypertension high-risk population in Haikou City community, so as to provide scientific evidence for the prevention and treatment of cardiovascular diseases (CVD). The multi-stage cluster sampling method was used, and 295 hypertension high-risk participants were recruited from 15 communities in Haikou City from July to December 2021. The 15 communities were randomly divided into three groups: blank group, traditional group and Internet plus group by random number table method. The blank group referred to the group (99 participants) that did not take special intervention measures but the routine interventions in accordance with the "National Basic Public Health Service Standards (the Third Edition) Health Education Service Standards". On the basis of the blank group, the traditional group (95 participants) was intervened by giving additional traditional methods such as holding lectures and distributing popular science books. The Internet plus group (101 participants) was given additional Internet measures on the basis of the intervention of the traditional group. After 6 months, questionnaires, laboratory biochemical tests, and physical measurements were conducted. SPSS 25.0 software was applied for data analysis. Measurement data that followed normal distribution were statistically described by using mean±standard deviation, analysis of variance was used for inter group comparisons before intervention, analysis of covariance was used for inter group comparisons after intervention, and Bonferroni adjustment was used for pairwise comparisons between groups. Measurement data that did not follow the Normal distribution were represented by M (Q₁, Q₃). The rank sum test was used for inter group comparison. The k sample Kruskal Wallis single factor ANOVA was used to compare the distribution between different groups. Counting data were described by composition ratio or rate. Under the premise of balanced comparison between groups before intervention, Chi-squared test was used for inter group comparison after intervention, and Bonferroni adjustment method was used for pairwise comparison between groups. The results showed that a total of 295 participants were included, with males accounting for 35.6% (105) and females accounting for 64.4% (190). The age ranged from 55 to 74 years old, with an average age of (64.69±5.73) years. The number of married accounted for 95.6% (282 participants). There were no statistically significant differences in gender, age, family history, education level, occupation, marital status, drinking habits, regular exercise, dietary status, SBP (systolic blood pressure), DBP (diastolic blood pressure), pulse pressure difference, BMI (body mass index), folic acid, and 24-hour urine sodium among the three groups upon enrollment (P values>0.05). After the intervention, the drinking rate was as follows: Internet plus group (29, 28.7%)2=28.948, P<0.001); Regular exercise rate was higher in the Internet plus group (37, 36.6%) than in the traditional group (18, 18.9%) and the blank group (16, 16.2%) (χ²=13.476, P=0.001). After the intervention, compared with the participants in the blank group, the intake of energy, carbohydrate, dietary fiber, sodium and folic acid in the Internet plus group were significantly different (all P<0.05); Compared with the participants in the traditional group, the energy, carbohydrate and dietary fiber intake of the participants in the Internet plus group were significantly different (all P<0.05). After the intervention, the blood pressure levels in the Internet plus group [ SBP: (128.95±6.55) mmHg, DBP: (79.88±5.75) mmHg ] and the traditional group [ SBP: (129.63±8.41) mmHg, DBP: (79.77±7.73) mmHg ] were lower than those in the blank group [ SBP: (132.93±8.41) mmHg, DBP: (82.42±7.76) mmHg ] (SBP: F=9.417, P<0.001; DBP: F=6.967, P=0.001), the 24-hour urinary sodium level in the Internet plus group (143.63±38.58) mmol/24 h was lower than that in the traditional group (163.31±35.67) mmol/24 h and the blank group (154.14±35.52) mmol/24 h (F=11.509, P<0.001). In conclusion, compared with the traditional intervention mode, the "Internet plus diet self-management intervention" mode is more likely to promote the development of a healthy lifestyle for people at high risk of hypertension, effectively improve blood pressure and 24-hour urine sodium level, and facilitate CVD prevention.
Male ; Female ; Humans ; Middle Aged ; Aged ; Blood Pressure ; Self-Management ; Hypertension/prevention & control* ; Cardiovascular Diseases/prevention & control* ; Diet ; Sodium ; Internet ; Folic Acid

OBJECTIVES: This study aimed to investigate the association between periodontal indexes and biomarkers in gingival crevicular fluid (GCF) and preterm birth (PTB) in pregnancy, as well as to assess the clinical value of these indexes as predictors of PTB. METHODS: A nested case-control study was conducted. A total of 300 systematically healthy pregnant women were selected within 36 weeks of gestation and grouped according to the enrolled weeks. Periodontal indexes, including probing depth (PD), bleeding index (BI), gingival index (GI), and five biomarkers in GCF, including interleukin (IL)-1β, IL-6, tumor necrosis factor-α (TNF-α), prostaglandin E2 (PGE2), and 8-hydroxy-2-deoxyguanosine (8-OHdG) were measured at the enrolled date. The detailed birth outcome was recorded. RESULTS: Only women at 24-28 weeks of gestation per PTB case (four full-term births) were selected as controls subjects, PTB displayed significantly greater GI, BI, and 8-OHdG ( CONCLUSIONS Increased BI and 8-OHdG at 24-28 weeks of gestation are risk factors for PTB. Their combined detection may have some value in the prediction of PTB, but further studies with a larger sample size are needed to explore it and thus provide experiment evidence for establishing an early warning system for PTB in pregnant women with periodontal disease.
Biomarkers ; Case-Control Studies ; Female ; Gingival Crevicular Fluid ; Humans ; Infant, Newborn ; Periodontal Index ; Pregnancy ; Premature Birth

OBJECTIVES: To investigate the attitudes and skills of grief counseling in the front-line medical workers from coronavirus disease 2019 (COVID-19) designated hospitals in Wuhan for the bereaved family members and to provide the basis for proper hospital management strategies. METHODS: The convenience sampling method was applied to select 422 medical workers who kept touch with the bereaved family members in five COVID-19 designated hospitals in Wuhan from January to February 2020. Questionnaire regarding grief counseling attitudes and questionnaire regarding grief counseling skills were used to evaluate the attitudes and skills of grief counseling in medical workers. The scores of grief counseling attitudes and skills in group of different characteristics were further compared. Pearson correlation was used to analyze the attitudes and skills of grief counseling in medical workers. RESULTS: The scores of grief counseling attitudes in medical workers were 15-46 (33.00±9.31). Length of service, professional title, whether or not receiving relevant training, frequency of contact with bereaved family members contributed to impacting the medical workers' attitudes of grief counseling (all <0.05). The scores of grief counseling skills in medical workers were 9-30 (19.30±4.42). Length of service, professional title, religion, whether or not receiving relevant training, frequency of contact with bereaved family members contributed to impacting the medical workers' skills of grief counseling (all <0.05). There was a significant positive correlation between the attitudes and skills of grief counseling in the medical workers (=0.608, <0.01). CONCLUSIONS The attitudes and skills of grief counseling in the medical workers from COVID-19 designated hospitals in Wuhan still need to be improved. Grief counseling group and a long-term, comprehensive training system are recommended.
Attitude of Health Personnel ; Betacoronavirus ; China ; Coronavirus Infections ; psychology ; Counseling ; Grief ; Health Personnel ; psychology ; Hospitals ; Humans ; Pandemics ; Pneumonia, Viral ; psychology

Objective: Liver fibrosis is an important predictor of mortality in nonalcoholic fatty liver disease (NAFLD). Peripheral artery disease (PAD) and liver fibrosis share many common metabolic dysfunctions. We aimed to explore the association between PAD and risk of fibrosis deterioration in NAFLD patients. Methods: The study recruited 1,610 NAFLD patients aged ≥ 40 years from a well-defined community at baseline in 2010 and followed up between August 2014 and May 2015. Fibrosis deterioration was defined as the NAFLD fibrosis score (NFS) status increased to a higher category at the follow-up visit. PAD was defined as an ankle-brachial index of < 0.90 or > 1.40. Results: During an average of 4.3 years' follow-up, 618 patients progressed to a higher NFS category. PAD was associated with 92% increased risk of fibrosis deterioration [multivariable-adjusted odds ratio ( ): 1.92, 95% confidence interval ( ): 1.24, 2.98]. When stratified by baseline NFS status, the for progression from low to intermediate or high NFS was 1.74 (95% : 1.02, 3.00), and progression from intermediate to high NFS was 2.24 (95% : 1.05, 4.80). There was a significant interaction between PAD and insulin resistance (IR) on fibrosis deterioration ( for interaction = 0.03). As compared with non-PAD and non-IR, the coexistence of PAD and IR was associated with a 3.85-fold (95% : 2.06, 7.18) increased risk of fibrosis deterioration. Conclusion PAD is associated with an increased risk of fibrosis deterioration in NAFLD patients, especially in those with IR. The coexistence of PAD and IR may impose an interactive effect on the risk of fibrosis deterioration.
Adult ; Aged ; Aged, 80 and over ; Ankle Brachial Index ; China ; epidemiology ; Female ; Humans ; Liver Cirrhosis ; epidemiology ; etiology ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; epidemiology ; etiology ; Peripheral Arterial Disease ; complications ; Prevalence ; Prospective Studies ; Risk Factors

The aim of the study was to establish Ace2 (angiotensin-converting enzyme 2) knockout mouse model with CRISPR/Cas9 gene targeting technology. A vector targeting Ace2 gene knockout was constructed with the primers of single-guide RNA (gRNA), and then transcribed gRNA/Cas9 mRNA was micro-injected into the mouse zygote. The deletion of exons 3 to 18 of Ace2 gene in mice was detected and identified by PCR and gene sequencing. The Ace2 gene knock-out mice were bred and copulated. Ace2 protein and mRNA expression were detected by Western blot and qRT-PCR in F3 progeny knock-out male mice. The gRNA expression vector was successfully constructed and transcribed in vitro, and active gRNA and Cas9 mRNA were injected directly into zygote. The deletion of exons 3 to 18 of Ace2 gene in six positive founder mice as the F0 generation were confirmed by PCR and gene sequencing. Six founder mice were mated with wild-type mice, then achieved F1 generation were mated and produced F2 generation. The female positive mouse of F2 was selected to mate with wild-type mice and produce Ace2 mice of F3 generation. Ace2 mRNA and protein were not detected in tissues of these Ace2 mice. In conclusion, a mouse model with Ace2 deficiency has been successfully established with CRISPR/Cas9 technique, which shall lay a foundation for future investigation of Ace2.
Animals ; CRISPR-Cas Systems ; Female ; Gene Knockout Techniques ; Gene Targeting ; Male ; Mice ; Mice, Knockout ; RNA, Guide ; genetics