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 investigate the correlation between CT manifestations of intramural vascular abnormalities and pathological subtypes,ground glass types in ground-glass opacity (GGO) lung adenocarcinoma.Methods CT data of 50 patients (55 lesions) with GGO lung adenocarcinoma confirmed by operative pathology were analyzed.The vascular morphology was observed.Correlation between vascular abnormalities (vascular thickening and hyperplasia) and pathological subtypes,ground glass types in GGO lung adenocarcinoma were analyzed.Results Among 55 GGO lung adenocarcinoma lesions,5 were pre-invasive lesions,no vascular thickening was observed,whereas vascular increasing was noticed in 1 lesion.Among 16 minimally invasive adenocarcinomas (MIA),vascular thickening and vascular increasing were observed in 11 and 16 lesions,respectively.All 34 invasive adenocarcinomas (IAC) were found with vascular thickening and increasing.The overall difference of vascular thickening and vascular increasing among pre-invasive lesions,MIA and IAC was statistically significant (x2 =27.67,20.08,both P＜0.05).There was positive correlation between pathological subtypes and vascular thickening and vascular increasing (r=0.61,0.66,P＜0.01).Significant differences of vascular thickening were found between pre-invasive lesions and MIA (x2=9.19,P=0.01),pre-invasive lesions and IAC (x2 =29.87,P＜0.01),as well as MIA and IAC (x2 =12.63,P＜0.01).There were significant differences of vascular increasing between pre-invasive lesions and MIA,pre-invasive lesions and IAC (x2 =15.45,20.79,both P＜0.01).Of all 55 GGO lung adenocarcinoma lesions,25 were pGGO,17 with vascular thickening and 21 vascular increasing;30 were mGGO,28 with vascular thickening and 30 vascular increasing.There were significant differences of vascular thickening and increasing in pGGO and mGGO (x2=6.12,6.69,both P＜0.05).Conclusion Vascular abnormalities in GGO lung adenocarcinoma suggest increasing of invasion.Vascular thickening and increasing can occur independently.

Objective To investigate the effect of Exosomes derived from lung cancer cells on the migration of secretory cells and homologous tumor cells and to explore the role of PI3K/Akt and SRC signaling pathways in this process.Methods Exosomes were isolated from the supematant post density gradient centrifugation of A549,lung cancer cells.Morphology of the Exosomes was studied using transmission electron microscopy.Protein expression was analyzed using Western blotting.Cell migration was analyzed by a transwell assay.Results The double-membrane-bound Exosomes appeared as discal-shaped structures,30-100 nm in diameter.Western blotting showed that CD9 was abundant in the Exosomes.The Exosomes promoted the migration of A549 cells and their homologous tumor cells,HCC827 in a dose-dependent manner,accompanied by the activation of Akt and SRC.Conclusion The Exosomes derived from A549 (lung cancer) cells promote the migration of the secreting cells and the homologous tumor cells.The mechanism may be correlated with the activation of Akt and SRC.

Objective To explore the effect of Exosomes isolated from the A549 lung cancer cells on the proliferation of these cells and their ho?mologous tumor cells,HCC827,and the role of the PI3K/Akt and SRC signaling pathways in this process. Methods Exosomes were isolated from the supernatant after density gradient centrifugation of A549 cells. The Exosomes morphology was observed by transmission electron microscopy. The expression of the Exosome?specific proteins was analyzed using Western blotting. Cell proliferation was investigated using the MTT assay. Re?sults The A549?derived Exosomes were 30?100 nm in diameter and had a bilayer membrane.Western blotting showed that CD9 was detected in these Exosomes. The isolated Exosomes promoted the proliferation of the A549 and the HCC827 cells in a dose?and time?dependent manner,ac?companied by the activation of Akt and SRC. Conclusion Exosomes isolated from A549 cells promote the proliferation of the secreting cells and the homologous tumor cells in a dose?and time?dependent manner. The mechanism may be related to the activation of Akt and SRC.

Objective To investigate the diagnostic significance of thin layer reconstruction with spiral CT on the pulmonary hamartoma. Methods Accepted both routine CT examination and thin layer construction,2 1 pulmonary hamartoma cases confirmed by pathology were analyzed retrospectively.The margin and inner features of the lesions were observed and recorded.Significant analysis was performed by using SPSS17.0 Pearson chi-square test and Fisher exact test,with P<0.05 as the significant difference criterion.Results Comparison of the display rates by routine CT and thin layer reconstruction:①the same display rate of lobulation were 57.1%(12/21);②the same display rate of calcification were 42.9% (9/21);③the display rates of fat density were 14.3%(3/21)by routine CT and 42.9% (9/21)by thin layer reconstruction.The difference was statistically significant (χ2=4.200,P<0.05);④the display rates of blood vessel throughing were 14.3%(3/21)by routine CT and 47.6% (10/21)by thin layer reconstruction.The difference was statistically significant (χ2=5.459,P<0.05).Conclusion Displaying the inner features of pulmonary hamartoma better than routine CT,the thin layer reconstruction can improve the diagnostic accuracy significantly.

An analytical method for simultaneous determination of five quinolones in spicy soup was developed. Spicy soup samples were firstly extracted by EDTA-Mcllvaine buffer at pH 4, then purified and concentrated by a novel Packed fiber solid phase extraction ( PFSPE ) coulumn. The extracted liquid supernatant was loaded onto the column, rinsed with water, and then eluted with 2% ammoniated methanol. The mobile phase was methanol-water-phosphoric acid (25:75:0. 1, V/V, adjusting the pH to 2. 8 with triethylamine) . These analytes were quantified by high performance liquid chromatography-fluorimetric detector( HPLC-FLD) at excitation and emission wavelength of 280 nm and 450 nm respectively. Recoveries of spiked quinolone antibiotics in spicy soup were from 72 . 1% to 110 . 3% with intraday relative standard deviation (RSD) between 1. 6% and 4. 3% and inter-day RSD from 2. 0% to 4. 3%. Limit of detection (LOD) and limit of quantitation(LOQ) were from 1. 2 to 5. 4 μg/L and from 3. 9 to 18 μg/L, respectively. The method could be applied to determine the quinolones in spicy soup.

Objective To explore the instructive value of preoperative splenic artery CTA examination on Laparoscopic splenectomy (LS). Methods From January 2008 to February 2010,36 cases requiring Laparoscopic splenectomy (LS) were selected randomly and divided into two groups: CTA group and non-CTA group, 18 cases in each group. As for the CTA group,splenic artery CTA examination was performed before operation,to understand splenic artery and its branches anatomy type and track and then individualized surgical treatment was developed. As for the non-CTA group,a routine surgical procedure was performed. The indices before and during the operation were recorded and compared through χ2 test The operating time and the amount of bleeding in the two groups were compared using t-test Results There were no significant difference between the indices recorded by splenic artery CTA examination and those by laparoscopic splenectomy intraoperation ( P > 0. 05 ) . The operating time was (124. 32 ±21.43) mins in the CTA group, which was significantly shorter than that in the non-CTA group ((148.27 ±28. 36)mins) (P <0. 05). The amount of blood in the CTA group was significantly less than that in the non-CTA group( ( 80. 50 ± 16. 42) ml vs. (101. 35 ± 26.25 ) ml). Conclusions Splenic artery CTA can identify splenic artery and its branches anatomy type and track before LS,therefore guide the development of individualized surgical treatment It increases the safety of LS, reduces bleeding and shortens the operational time. It has an instrutive value to laparoscopic splenectomy.

BACKGROUND: Acetabular cup orientation using a standard radiograph of the pelvis is quite common method to assess artificial hip replacement nowadays. Non-standardization of pelvic orientation affected accuracy of measurement results, and it is difficult to compare. OBJECTIVE: To make sure how pelvis tilting affect the anteveration of the cup and to elevate clinical accuracy and compare study comparability. METHODS: Designed a simulated acetabular cup with serial concentric circles which pass through the same polars and represent anteveration of 0°, 10°, 20°, 30°, 40°, Loaded the simulated acetabular cup at an inclination of 35°, 40°, 45°, 50°, 55° to6 cadaver pelves, Made the pelves tilt around the frontal axis and sagittal axis with 5° each time in a scope of+30°. Takestandard radiograph of the pelvis accordingly. Radiograph was photographed end frontal angle of dip was measured. RESULTS AND CONCLUSION: Pelvic tilt of about 1° causes measuring errors of anteveration 0. 61 °-0. 73°. The anteveration decreased at both acetabular cups when pelvic posterior tilt and at the acetabular cup that near the X-ray source as pelvic lateral tilt. The anteveration rose at both acetabular cups when pelvic anterior tilt and at the acetabular cup that away from the X-ray source as pelvic lateral tilt. During clinical evaluation, pelvic orientation effects on measurement results should be considered.

OBJECTIVETo examine the expression of the tau protein and microtubule-associated proteins in the testis interstitium of aged and young rats.

METHODSSprague-Dawley male rats were divided into a young group(6 months, n = 10) and an aged group(28 months, n = 10). The two steps immunohistochemistry method with the antibody against tau protein and MAP alpha was performed on the testis tissues of the rats.

RESULTSThe results showed that the immunoreactive cells of tau protein of the testis interstilial of the aged rats obviously increased(P < 0.001) than those of the young, while the immunoreactive cells of the microtubule-associated proteins decreased(P < 0.01) in the aged.

CONCLUSIONThe changes in the expression of the tau protein and microtubule-associated proteins may be related to the aging process of the testis.

Aging ; metabolism ; Animals ; Immunohistochemistry ; Male ; Microtubule-Associated Proteins ; analysis ; Rats ; Rats, Sprague-Dawley ; Testis ; chemistry ; tau Proteins ; analysis