Objective: To evaluate the health risk of drinking water in Ningbo City, Zhejiang Province from 2021 to 2022, so as to provide insights into ensuring the safety of drinking water. Methods: The monitoring data of drinking water from 2021 to 2022 in Ningbo City were collected from the Chinese Disease Prevention and Control Information System. The routine indicators and disinfectant indicators (radioactivity indicators were excluded) of drinking water were evaluated according to the reference limits issued by Standards for Drinking Water Quality (GB 5749-2006), and the qualification rates were calculated. The indicators with detection rate higher than 50% were selected, and assessed the carcinogenic and non-carcinogenic risks via drinking water using the risk assessment model recommended by the United States Environmental Protection Agency. Results: A total of 1 678 samples were monitored in Ningbo City from 2021 to 2022. Sodium hypochlorite was the main disinfectant among 1 558 samples from centralized water supply (1 079 samples, 64.30%), and none of the 120 samples from decentralized water supply underwent disinfection treatment. The qualification rate of 88.38%, and the pollutants with a detection rate higher than 50% were nitrate, fluoride, trichloromethane and aluminum. The median carcinogenic risk value of trichloromethane was 2.964×10-6 (interquartile range, 3.909×10-6), and the median hazard quotient values of nitrate, fluoride, trichloromethane and aluminum were 1.631×10-2 (interquartile range, 1.361×10-2), 3.955×10-2 (3.164×10-2), 2.231×10-2 (2.942×10-2) and 2.136×10-4 (6.573×10-4), respectively. Conclusion The carcinogenic and non-carcinogenic risks through drinking water for 17 pollutants in drinking water of Ningbo City from 2021 to 2022 were at low levels.

【Objective】 To investigate the effects of radical prostatectomy (RP) or brachytherapy (BT) on the prognosis of patients with high-risk prostate cancer as initial treatment, in order to provide a reference for the selection of clinical treatment options. 【Methods】 The clinical data of 133 191 patients diagnosed with high-risk prostate cancer and treated with RP or BT during 2005 and 2014 were extracted from the SEER database.The 5-year and 10- year cancer-specific survival (CSS) and overall survival (OS) were compared with K-M analysis and univariate and multivariate Cox regression.The clinical data of another 253 patients diagnosed with high-risk prostate cancer in Subei People’s Hospital during 2015 and 2020 were collected, including 153 patients who received RP and 100 patients who received BT.The 5-year biochemical progress-free survival (bPFS) and CSS were compared with K-M analysis. 【Results】 Univariate analysis of SEER data showed that BT was associated with a higher risk of death (HR=1.319, 95%CI: 1.256-1.386, P<0.001); age, marital status and TNM stage were associated with higher risk of death (P<0.001).Multivariate analysis, adjusted for relevant variables, showed that BT did not result in a higher risk of death compared with RP (HR=0.964, 95%CI:0.924-0.996, P=0.808). The OS curve showed that the longer the observed survival time, the better OS of RP as compared to BT (P<0.001); however, the CSS survival curve showed that the longer the observed survival time, the better CSS of BT compared to RP (P<0.001).The single-center data analysis showed no significant difference between BT and RP in the 5-year bPFS (P=0.263) and CSS (P=0.946). 【Conclusion】 For patients with high-risk prostate cancer, there is a significant difference in the prognosis of the two treatments if there is no adjustment of age, marital status, TNM stage and other factors, and the efficacy of RP is better than that of BT, especially in patients with survival more than 10 years.However, there is no statistically significant difference in the prognosis after the possible confounding factors are adjusted.Therefore, the initial treatment choice for these patients should be weighed from multiple perspectives, and patients’ choices must be respected after they are fully informed.

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 study the optimization of defecation treatment in patients with chronic constipation under different positions and angles by "simulation contrast agent".Methods:The clinical data of 78 patients with chronic constipation in Handan Central Hospital from April 2020 to April 2022 were retrospectively analyzed. Among them, 26 patients were examined by 90°conventional defecography position (conventional position group), 26 patients by 60° to 89° defecography position (61° to 89° position group), and 26 patients by 30° to 59° Asian squat defecography position (Asian squat position group). The results of defecography, constipation score and defecography abnormality were compared among the three groups.Results:The encysted rectum, internal rectal intussusception and descending distance of perineum in 61° to 89° position group and Asian squat position group were significantly lower than those in conventional position group: (2.71 ± 0.25) and (2.11 ± 0.66) mm vs. (3.06 ± 0.23) mm, (9.06 ± 1.78) and (8.55 ± 2.81) mm vs. (10.22 ± 1.59) mm, (11.52 ± 2.70) and (10.52 ± 2.93) mm vs. (12.52 ± 3.43) mm, the indexes in Asian squat position group were significantly lower than those in 61° to 89° position group, and there were statistical differences ( P<0.01); the anal right angle and the anal right angle in force discharge state in 61° to 89° position group and Asian squat position group were significantly higher than those in conventional position group: (120.47 ± 3.35)° and (122.44 ± 3.33)° vs. (118.19 ± 3.66)°, (19.99 ± 3.47)° and (20.25 ± 2.69)° vs. (18.77 ± 2.79)°, the indexes in Asian squat position group were significantly higher than those in 61° to 89° position group, and there were statistical differences ( P<0.01); there was no statistical difference in resting anal right angle among the three groups ( P>0.05). The Longo outlet obstructive constipation score, Wexner constipation score and constipation severity score in 61° to 89° position group and Asian squat position group were significantly lower than those in conventional position group: (14.41 ± 2.66) and (12.24 ± 3.49) scores vs. (16.64 ± 3.37) scores, (13.79 ± 2.74) and (12.83 ± 3.08) scores vs. (15.76 ± 3.56) scores, (13.34 ± 2.72) and (12.31 ± 2.52) scores vs. (16.08 ± 3.57) scores, the indexes in Asian squat position group were significantly lower than those in 61° to 89° position group, and there were statistical differences ( P<0.01). The detection rates of abnormal defecography in conventional position group, 61° to 89° position group and Asian squat position group were 96.15% (25/26), 84.62% (22/26) and 69.23% (18/26), and there was statistical difference ( P<0.05); among them, the detection rate of abnormal defecography in Asian squat position group was significantly lower than that in conventional position group, and there was statistical difference ( P<0.05). Conclusions:The defecation function and imaging indexes are optimized in patients with chronic constipation based on the guidance of "simulation contrast agent" adopted the Asian squat position, and their significantly.

Objective: To investigate the protective effect of cordycepin( Cor) on cardiac function in aged rats and its mechanism． Methods : The aged rats were divided into Model group，Cor administration group ( Cor 5，10，20g / kg) ，and young rats were used as Control group ( Control) ．The levels of heart rate (HR) ，left ventricular e- jection fraction (LVEF) and fractional shortening (FS) were detected by echocardiography．The levels of creatine kinase MB ( CK-MB) ，myohemoglobin (Mb) ，cardiac troponin Ⅰ (cTnI) ，superoxide dismutase (SOD) ，malon- dialdehyde (MDA) and lactate dehydrogenase ( LDH) were detected by ELISA．The pathological morphology of heart tissue was observed by HE staining． The apoptosis of myocardial cells was observed by TUNEL staining. Western blot detected the protein expression of cysteine aspartic protease 9 ( Caspase 9) ，cleaved cysteine aspartic protease 9 (cleaved Caspase 9) ，cysteine aspartic protease 3 ( Caspase 3 ) ，cleaved cysteine aspartic protease 3 ( cleaved Caspase 3) ，nuclear factor E2 related factor 2 (Nrf2) ，phosphorylation nuclear factor E2 related factor 2 (p-Nrf2) ，quinone oxidoreductase 1 (NQO1) ，heme oxygenase 1 ( HO-1) . Results : Compared with the elderly model group，HR , LVEF ，FS increased ，CK-MB ，Mb ，cTnI levels decreased ，MDA ，LDH content decreased， SOD activity increased，cleaved Caspase 9 / Caspase 9，cleaved Caspase 3 / Caspase 3 expression decreased，The ex- pressions of Nrf2，NQO1 and HO-1 were increased，and the pathological morphology of cardiac tissue and myocar- dial apoptosis were improved in Cor groups． Conclusion Cor can improve cardiac function of elderly rats，relieve oxidative stress response，inhibit myocardial cell apoptosis and have a certain protective effect on cardiac tissue in- jury in rats，and the mechanism may be related to the promotion of Nrf2 / HO-1 pathway related protein expression.

Objective    To compare the clinical effects of segmentectomy and lobectomy for ≤2 cm lung adenocarcinoma with micropapillary and solid subtype negative by intraoperative frozen sections. Methods    The patients with adenocarcinoma who received segmentectomy or lobectomy in multicenter from June 2020 to March 2021 were included. They were divided into two groups according to a random number table, including a segmentectomy group (n=119, 44 males and 75 females with an average age of 56.6±8.9 years) and a lobectomy group (n=115, 43 males and 72 females with an average of 56.2±9.5 years). The clinical data of the patients were analyzed. Results    There was no significant difference in the baseline data between the two groups (P>0.05). No perioperative death was found. There was no statistical difference in the operation time (111.2±30.0 min vs. 107.3±34.3 min), blood loss (54.2±83.5 mL vs. 40.0±16.4 mL), drainage duration (2.8±0.6 d vs. 2.6±0.6 d), hospital stay time (3.9±2.3 d vs. 3.7±1.1 d) or pathology staging (P>0.05) between the two groups. The postoperative pulmonary function analysis revealed that the mean decreased values of forced vital capacity and forced expiratory volume in one second percent predicted in the segmentectomy group were significantly better than those in the lobectomy group (0.2±0.3 L vs. 0.4±0.3 L, P=0.005; 0.3%±8.1% vs. 2.9%±7.4%, P=0.041). Conclusion    Segmentectomy is effective in protecting lungs function, which is expected to improve life quality of patients.

Objective:The hemagglutintin (HA) gene of human influenza viruses of H3N2 subtype circulating in Nanjing from 2014 to 2016 was sequenced, and the genetic variation and evolution characteristics of HA gene were analyzed.Methods:Among the positive H3N2 influenza virus, a total of 27 strains were randomly selected according to the time period for virus isolation in MDCK cells. Viral RNA was extracted, HA gene of influenza virus was amplified by reverse transcritase polymerase chain reaction (RT-PCR) and sequenced. The molecular sequence characteristics were analyzed, and genetic evolution characteristics and important functional sites were further analyzed.Results:The HA nucleotide length of H3N2 Nanjing strains was 1 701 bp, encoding 566 amino acids. Highly homologous with WHO recommended vaccine strains in the same year, with sequence similarity of 97.9%-99.5%. Evolutionary analysis showed that the Nanjing strains from 2014 to 2016 were divided into two branches in the evolutionary tree, and realized the transformation from genotype 3c.3a to 3c.2a. Multiple epitope amino acid variations occurred in different years of Nanjing strains.Conclusions:The prevalent strains of H3N2 influenza virus in Nanjing from 2014 to 2016 have high homology with the vaccine strains, the vaccine can provide a certain protective effect. HA gene antigen variation and molecular genetic evolution are active, so it is necessary to continuously monitor the antigen site changes and genetic evolution characteristics of the virus, so as to prepare for the epidemic of H3N2 in the next influenza virus season.

As the proceeding of the Belt and Road, TCM industry in Russia develops steadily. Acupuncture and Tuina therapies have been accepted by the local people, while Chinese medicine is still around the acceptance. Right now, Russian economy is on a recovering stage, so it's good time for TCM to carry service trading during this time. TCM development in Russia need to focus on the input of medical resources, managements and regulations, proceeding TCM teaching work and bringing along TCM service trade by acupuncture therapy.

Objective: To investigate the expression of Golgi protein 73 (GP73) in liver cirrhosis and its assistant value in grading of liver cirrhosis. Methods: A total of 160 patients with liver cirrhosis (96 males, 64 females, age: (58.6±10.3) years) and 60 healthy controls (35 males, 25 females, age: (53.5±12.2) years) were included to detect the GP73 level. Serum levels of alpha-fetoprotein (AFP), albumin (ALB), total bilirubin (TBIL) and prothrombin time (PT) were also measured. The correlations between the above indicators and the GP73 level were analyzed with Pearson correlation. The GP73 levels among patients with different Child-Pugh grading and different CT morphological grading were compared using one-way analysis of variance and the least significant difference t test. The receiver operating characteristic (ROC) curve analysis was used to analyze the diagnostic sensitivity and specificity of GP73/AFP for liver cirrhosis. Results: The area under the ROC curve for GP73 was 0.886 with the cut-off value of 144.5 μg/L. The sensitivity of GP73 in the diagnosis of liver cirrhosis was 70.4%, and the specificity was 87.8%. After combining with AFP, the sensitivity and specificity were elevated to 71.6% and 90.2% respectively. GP73 levels among patients with different Child-Pugh grading and those with different CT morphological grading were significantly different (F: 3.15, 2.82, both P<0.05), and GP73 levels among groups also showed significant differences (all P<0.05). The GP73 level was correlated with AFP, ALB, TBIL, and PT (r values: 0.362, -0.428, 0.672, 0.575, all P<0.01). Conclusion Serum GP73 level increases with progression of liver cirrhosis, and it has an assistant value in the diagnosis of liver cirrhosis.

Objective To investigate the clinical features of elderly patients with stage 3-4 chronic kidney disease ( CKD ) and to analyze the risk factors of the kidney function progression. Methods This was a cross-sectional study. The clinic data of elderly patients (≥60 years) with stable clinical manifestation in Beijing Hospital from January ,2014 to December ,2015 was collected.Based upon the eGFR derived from Cockcroft-Gault (CG) equation ,all patients were divided into groups of CKD 3a group ,CKD 3b group and CKD 4 group ,respectively. Moreover ,patients were separated into the old group (＜ 80 years) and the very old group (≥80 years) based on the age. The demographic features ,primary diseases history ,body mass index (BMI) ,blood routine ,urine routine , blood biochemistry ,Cystatin C and iPTH were recorded.Logistic regression analysis of kidney function progression was also conducted. Results One-hundred and eighty-three cases were enrolled with a mean age of(80 ± 9)years.Along with the descent of kidney function ,the age ,levels of proteinuria and iPTH gradually ascended (F＝ 12.352 ,5.910 ,5.910 ;P＝ 0.000 ,0.003 ,0.003 ,respectively) and the BMI and serum albumin gradually descended (F＝9.758 ,11.088 ;P＝0.000 ,0.000 ,respectively).In addition ,compared to the old group ,very old group was associated with decreased level of eGFR [(37.1 ± 9.9) ml·min－1·1.73 m －2vs. (44.0 ± 12.0) ml·min－1·1.73 m －2,t＝ －4.280 ,P＝0.000] and increasedlevelofCystatinC[(1.71±0.84)mg/L vs. (1.40±0.69)mg/L ,t＝3.484 ,P＝0.001].The Logistic regression analysis indicated that the proteinuria was an independent risk factor for the progression of kidney function ( OR ＝3.856 ,P＝0.004). Conclusions As the gradually descended of the eGFR level in elderly patients with stage 3-4 CKD ,age ,proteinuria and iPTH gradually ascended ,BMI and serum albumin descended ,respectively. The level of eGFR decreased and CystatinC increased significantly with the increasing age. Proteinuria was an independent risk factor for progression of the kidney function.