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 translate the Self-Confidence Scale for Clean Intermittent Self-Catheterization (SCSCISC) into Chinese and test its reliability and validity.Methods:Following the Brislin questionnaire translation principles, the English version of SCCSISC was translated, back translated, culturally adapted, consulted with experts, and pre-surveyed to form the Chinese version of SCCSISC. From June to September 2023, 237 patients with neurogenic bladder admitted to the First Hospital of Shanxi Medical University were selected as survey subjects by the convenient sampling method. The critical ratio method was used for project analysis, and Cronbach's α coefficient, split half reliability, and test-retest reliability were used to evaluate the reliability of the scale. Content validity and construct validity were used to test the validity of the scale.Results:The Cronbach's α coefficient of the Chinese version of SCCSISC was 0.976, the split half coefficient was 0.962, and the test-retest reliability was 0.876. The item-level content validity index ( I- CVI) of the Chinese version of SCCSISC was 0.86 to 1.00, and the scale-level content validity index ( S- CVI) was 0.93, with Kappa consistency coefficients above 0.74. Two common factors were extracted through exploratory factor analysis, with a cumulative variance contribution rate of 73.42%. Conclusions:The Chinese version of SCCSISC has good reliability and validity, and can be used as a tool for self-confidence measurement of clean intermittent self-catheterization among patients with neurogenic bladder in China.

Objective:To investigate the clinical diagnostic value of MRI retention enema cannula enhanced scanning in the high complex anal fistula.Methods:The clinical data of 60 anal fistula patients underwent surgery treatment from May 2020 to May 2022 in Affiliated Hospital of Shanxi University of Traditional Chinese Medicine were retrospectively analyzed. All patients underwent MRI plain scanning and enhanced scanning before operation. Compared with the surgical results, the difference between MRI plain scanning and enhanced scanning in the diagnosis of high complex anal fistula was compared.Results:All of the 60 patients successfully completed surgical treatment, and 58 cases internal orifices, 55 cases complex anal fistulas and 53 cases high anal fistulas were found intraoperatively. MRI plain scanning results showed 32 cases internal orifices, 46 cases complex anal fistulas and 42 cases high anal fistulas were found. MRI enhanced scanning results showed 54 cases internal orifices, 53 cases complex anal fistulas and 50 cases high anal fistulas were found. Based on surgical results, the coincidence rates of internal orifice, complex anal fistula and high anal fistula in MRI enhanced scanning were significantly higher than those in MRI plain scanning: 93.10% (54/58) vs. 55.17% (32/58), 96.36% (53/55) vs. 83.64% (46/55) and 94.34% (50/53) vs. 79.25% (42/53), and there were statistical differences ( χ2 = 21.76, 4.95 and 5.27; P<0.01 or <0.05). Conclusions:The MRI retention enema cannula enhanced scanning has obvious advantages in the diagnosis of high complex anal fistula, which provides scientific reference value for the diagnosis and operation of high complex anal fistula in clinic.

Objective:To translate the Intermittent Catheterization Difficulty Questionnaire (ICDQ) into Chinese, and to test its reliability and validity in neurogenic bladder patients.Methods:After translation, back-translation, cross-cultural debugging, expert consultation and pre-investigation, a Chinese version of ICDQ was formed. A total of 248 patients with neurogenic bladder clean intermittent self-catheterization who were treated and followed up in the First Hospital of Shanxi Medical University in October 2022 were selected as research objects by the convenient sampling method, and the Chinese version of ICDQ was used for investigation. The critical ratio method was used for project analysis. Content validity and structure validity were used to test the validity of the questionnaire. Cronbach's α coefficient, split half reliability coefficient and retest reliability coefficient were used to test the reliability of the questionnaire. A total of 248 questionnaires were sent out in this study, and 238 were effectively collected, with a recovery rate of 95.97% (238/248) .Results:The Cronbach's α coefficient of the Chinese version of ICDQ was 0.857, the split half coefficient was 0.711, and the retest reliability coefficient was 0.954. The content validity index of the Chinese version of ICDQ item level was 0.860 to 1.000, and the content validity index of the scale level was 0.930. Seven common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 77.38%. The results of confirmatory factor analysis showed RMSEA < 0.080, GFI, AGFI, TLI, CFI > 0.800. Conclusions:Through confirmatory factor analysis, the Chinese version of ICDQ shows that the model fitting indicators of the scale meet the corresponding requirements, indicating that the scale has high structural validity and overall model fitting. It can be used as an evaluation tool for intermittent self catheterization difficulties in patients with neurogenic bladder.

ObjectiveTo study the mechanism of Shenling Guchang prescription on blood glucose of gestational diabetes mellitus rats by regulating intestinal flora and short chain fatty acids. MethodThe 30 pregnant rats were randomly selected from 36 pregnant rats which were successfully pregnant. The model rats were fed with high-fat and high-sugar diet for 1 week， and 35 mg·kg^-1 streptozotocin （ STZ ） was given for 3 consecutive days to construct a gestational diabetes model. After successful modeling， the rats were randomly divided into model group， metformin group， Shenling Guchang prescription low-， medium- and high-dose group. The high dose group of Shenling Guchang prescription was given 18 mg·kg^-1， the middle dose group was given 9 mg·kg^-1， the low dose group was given 4.5 mg·kg^-1 drug solution by gavage， the metformin group was given 52.5 mg·kg^-1 drug solution by gavage， the blank group and the model group were given equal volume of normal saline by gavage.At 24 h after the last administration， blood samples were collected from the tail tip of the rats to measure the blood glucose， and blood samples were collected from the abdominal aorta under anesthesia to measure the levels of triglyceride （TG）， total cholesterol （TC）， high density lipoprotein cholesterol （HDL-C） and low density lipoprotein cholesterol （LDL-C）. Lipopolysaccharides （LPS）， interleukin-1β （IL-1β）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α） and insulin （INS） were detected by enzyme-linked immunosorbent assay （ELISA）.The intestinal tissue of rats was taken， and the pathological changes of intestinal tissue were observed by hematoxylin-eosin （HE） staining. Fecal samples were collected from rats， 16S rRNA sequencing was used to detect intestinal flora， and short-chain fatty acids were detected by gas chromatography. ResultCompared with the blank group， the incidence of adverse pregnancy outcomes in the model group was significantly increased （P<0.05）. Compared with the model group， the incidence of adverse pregnancy outcomes in the Shenling Guchang prescription groups and the metformin group was significantly decreased （P<0.05）. Compared with the blank group， the levels of blood glucose， TG， TC， HDL-C， LDL-C， LPS， IL-1β， IL-6 and TNF-α in the model group were significantly increased （P<0.05）， and the intestinal tissues had different degrees of inflammatory changes and mucosal damage. Compared with the model group， the levels of blood glucose， TG， TC， HDL-C， LDL-C， LPS， IL-1β， IL-6 and TNF-α in each group of Shenling Guchang prescription and metformin group were down-regulated （P<0.05）， and intestinal inflammation and intestinal mucosal damage were improved. Compared with the blank group， the functional structure and diversity of intestinal flora in the model group changed （P<0.05）. Compared with the model group， the functional structure and diversity of intestinal flora in the Shenling Guchang prescription groups and the metformin group were reversed， and the trend was close to the blank group （P<0.05）.Compared with the blank group， the abundance of pathogenic bacteria such as Escherichia coli， Enterococcus， Klebsiella， and Dustella in the model group was significantly increased， and the abundance of probiotics such as Prevotella， Prevotella， Akmania， Rombustella， and Lachnospiraceae was decreased （P<0.05）. Compared with the model group， the abundance of pathogenic bacteria such as Escherichia coli， Enterococcus， Klebsiella， and Dustella was decreased （P<0.05）， and the abundance of probiotic bacteria such as Prevotella， Akmanella， Rombustella， and Lachnospira was increased （P<0.05） in the Shenling Guchang prescription groups and the metformin group. Compared with the blank group， the content of short-chain fatty acids in the model group was significantly decreased （P<0.05）. Compared with the model group， the content of short-chain fatty acids in each group of Shenling Guchang prescription and metformin group increased （P<0.05）. Correlation analysis showed that Proteobacteria was positively correlated with inflammatory factors， blood glucose and blood lipid in gestational diabetes mellitus （P<0.05）. ConclusionShenling Guchang prescription has a good regulatory effect on blood glucose， blood lipids and adverse pregnancy outcomes in rats with gestational diabetes mellitus. Its efficacy is comparable to that of metformin sustained-release tablets. Its mechanism may be related to regulating the structure of intestinal flora， increasing the content of short-chain fatty acids， reducing LPS， IL-1β， IL-6， TNF-α， and improving intestinal inflammation.

Objective:To investigate the clinical efficacy of B-mode ultrasound guided percutaneous extensor tendon insertion reconstruction in the treatment of tendinous mallet fingers.Methods:A retrospective analysis was performed on the data of patients with mallet finger deformity admitted to the Department of Hand Surgery of Jinan People’s Hospital from February 2010 to January 2019. Under the guidance of B-mode ultrasound, the extensor tendon was sutured percutaneously with PDS II monofilament suture, pulled to the base of the distal phalanx, which was drilled with a 1.0 mm Kirschner’s wire to reconstruct the insertion of the extensor tendon. The active and passive extension angles of the affected fingers and the wound healing were observed after operation. Evaluation of finger function using Crawford’s method.Results:A total of 58 cases were enrolled, including 48 males and 10 females, aged 20-53 years. 49 patients were followed up for 6 to 15 months after operation, with an average of 11 months, and 9 patients were lost to follow-up. The active extension angle of the affected finger changed from 46.5°±7.2° before operation to 6.4°±0.5° after operation, and the difference was statistically significant before and after operation ( t=38.89, P<0.001). The passive extension angle decreased from 3.2° ±0.3°before operation to 0.9° ±0.2°after operation, and the difference was statistically significant before and after operation ( t=44.65, P<0.001). There were no complications such as exposed knots and skin necrosis. Evaluation by Crawford method: excellent in 29 cases, good in 12 cases, and fair in 8 cases. Conclusions:Percutaneous ultrasound-guided extensor finger tendon insertion reconstruction, minimally invasive surgery, in the treatment of tendon mallet finger function recovered well, and the effect was satisfactory.

Objective:To investigate the clinical efficacy of B-mode ultrasound guided percutaneous extensor tendon insertion reconstruction in the treatment of tendinous mallet fingers.Methods:A retrospective analysis was performed on the data of patients with mallet finger deformity admitted to the Department of Hand Surgery of Jinan People’s Hospital from February 2010 to January 2019. Under the guidance of B-mode ultrasound, the extensor tendon was sutured percutaneously with PDS II monofilament suture, pulled to the base of the distal phalanx, which was drilled with a 1.0 mm Kirschner’s wire to reconstruct the insertion of the extensor tendon. The active and passive extension angles of the affected fingers and the wound healing were observed after operation. Evaluation of finger function using Crawford’s method.Results:A total of 58 cases were enrolled, including 48 males and 10 females, aged 20-53 years. 49 patients were followed up for 6 to 15 months after operation, with an average of 11 months, and 9 patients were lost to follow-up. The active extension angle of the affected finger changed from 46.5°±7.2° before operation to 6.4°±0.5° after operation, and the difference was statistically significant before and after operation ( t=38.89, P<0.001). The passive extension angle decreased from 3.2° ±0.3°before operation to 0.9° ±0.2°after operation, and the difference was statistically significant before and after operation ( t=44.65, P<0.001). There were no complications such as exposed knots and skin necrosis. Evaluation by Crawford method: excellent in 29 cases, good in 12 cases, and fair in 8 cases. Conclusions:Percutaneous ultrasound-guided extensor finger tendon insertion reconstruction, minimally invasive surgery, in the treatment of tendon mallet finger function recovered well, and the effect was satisfactory.

Objective:To investigate the clinical efficacy of B-mode ultrasound guided percutaneous extensor tendon insertion reconstruction in the treatment of tendinous mallet fingers.Methods:A retrospective analysis was performed on the data of patients with mallet finger deformity admitted to the Department of Hand Surgery of Jinan People’s Hospital from February 2010 to January 2019. Under the guidance of B-mode ultrasound, the extensor tendon was sutured percutaneously with PDS II monofilament suture, pulled to the base of the distal phalanx, which was drilled with a 1.0 mm Kirschner’s wire to reconstruct the insertion of the extensor tendon. The active and passive extension angles of the affected fingers and the wound healing were observed after operation. Evaluation of finger function using Crawford’s method.Results:A total of 58 cases were enrolled, including 48 males and 10 females, aged 20-53 years. 49 patients were followed up for 6 to 15 months after operation, with an average of 11 months, and 9 patients were lost to follow-up. The active extension angle of the affected finger changed from 46.5°±7.2° before operation to 6.4°±0.5° after operation, and the difference was statistically significant before and after operation ( t=38.89, P<0.001). The passive extension angle decreased from 3.2° ±0.3°before operation to 0.9° ±0.2°after operation, and the difference was statistically significant before and after operation ( t=44.65, P<0.001). There were no complications such as exposed knots and skin necrosis. Evaluation by Crawford method: excellent in 29 cases, good in 12 cases, and fair in 8 cases. Conclusions:Percutaneous ultrasound-guided extensor finger tendon insertion reconstruction, minimally invasive surgery, in the treatment of tendon mallet finger function recovered well, and the effect was satisfactory.

Objective:To investigate the clinical efficacy of B-mode ultrasound guided percutaneous extensor tendon insertion reconstruction in the treatment of tendinous mallet fingers.Methods:A retrospective analysis was performed on the data of patients with mallet finger deformity admitted to the Department of Hand Surgery of Jinan People’s Hospital from February 2010 to January 2019. Under the guidance of B-mode ultrasound, the extensor tendon was sutured percutaneously with PDS II monofilament suture, pulled to the base of the distal phalanx, which was drilled with a 1.0 mm Kirschner’s wire to reconstruct the insertion of the extensor tendon. The active and passive extension angles of the affected fingers and the wound healing were observed after operation. Evaluation of finger function using Crawford’s method.Results:A total of 58 cases were enrolled, including 48 males and 10 females, aged 20-53 years. 49 patients were followed up for 6 to 15 months after operation, with an average of 11 months, and 9 patients were lost to follow-up. The active extension angle of the affected finger changed from 46.5°±7.2° before operation to 6.4°±0.5° after operation, and the difference was statistically significant before and after operation ( t=38.89, P<0.001). The passive extension angle decreased from 3.2° ±0.3°before operation to 0.9° ±0.2°after operation, and the difference was statistically significant before and after operation ( t=44.65, P<0.001). There were no complications such as exposed knots and skin necrosis. Evaluation by Crawford method: excellent in 29 cases, good in 12 cases, and fair in 8 cases. Conclusions:Percutaneous ultrasound-guided extensor finger tendon insertion reconstruction, minimally invasive surgery, in the treatment of tendon mallet finger function recovered well, and the effect was satisfactory.

Objective:To explore the effect of comprehensive gastrointestinal training on the recovery of gastrointestinal function after radical cystectomy (Bricker′s operation).Methods:Seventy-one elderly bladder cancer patients who had undergone Bricker′s operation were randomly divided into a control group of 34 and an observation group of 37. Both groups were given routine treatment, while the observation group was additionally provided with comprehensive gastrointestinal training immediately after the operation. Plasma gastrin was measured before the operation and on the 1st and 3rd day afterward. The return of peristaltic sounds, the exhausting and defecation time, the incidence of intestinal obstruction and the average hospital stay were recorded. On the 7th, 14th, 21st and 28th day after the operation, both groups′ gastrointestinal functioning was scored by using Gastrointestinal Symptom Rating Scale (GSRS).Results:The levels of plasma gastrin in the observation group were significantly higher than before the surgery and significantly higher than those in the control group on the 1st and 3rd day after the surgery, though there had been no significant difference between the two groups before the operation. Compared with the control group, peristaltic sounds returned significantly earlier in the observation group (after 1.22±0.15d), and the group′s exhaust time (1.88±0.22d) and first defecation time (2.95±0.19d) were also better. The incidence of intestinal obstruction (23.53%) was significantly lower in the observation group as well. The observation group recorded lower average GSRS values than the control group throughout the observation and follow-up periods, and their average hospital stay was significantly shorter.Conclusion:Comprehensive gastrointestinal training can effectively promote recovery after radical bladder cystectomy.