Objective: To classify the ABO blood group phenotypes of 5 cases from a family, and to explore the molecular mechanism for reduced B antigen expression in ABO blood group system. Methods: Serological identification of the ABO blood group was performed using microcolumn gel assay and saline tube method. The soluble antigens in saliva were detected by the agglutination inhibition assay. The full-length sequences and upstream promoter regions of ABO gene were sequenced for genotyping using PacBio SMRT sequencing technology. Results: The results of serological tests indicated the expression of B antigen decreased in 3 out of 5 blood samples. A mixed-field agglutination was observed with anti-B antibody. B antigen was not detected in all 5 saliva samples. The ABO genotype for all samples were ABO B.01/ABO O.01.02, and a novel mutation c. 28+5875C>T within the DNA-binding region of RUNX1 in +5.8-kb site were found in the B allele for 3 samples with reduced expression of B antigen. Conclusion: Results of serological and genetic analyses classify the 3 cases with reduced B antigen expression as B phenotype. The novel mutation c. 28+5875C>T of RUNX1 could be the key reason for reduced B antigen expression in 3 cases with B phenotype.

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 effect of phlorizin on the apoptosis and oxidative stress of rat cardiomyocytes H9C2 induced by hypoxia/reoxygenation(H/R)and its possible mechanism.Methods H9C2 cells were cultured in vitro.H/R model was established after pretreatment with different doses(16,32,64 μmol/L)of phlorizin or transfection with anti-miR-125a-5p,anti-miR-NC,miR-125a-5p mimics and negative controls.Proliferation was detected by CCK-8,and apoptosis was detected by flow cytometry.The protein expression levels of B lymphoblastoma-2 associated X protein(Bax)and B lymphocytoma-2(Bcl-2)were detected by Western blot assay.The release of lactate dehydrogenase(LDH)and the activity of superoxide dismutase(SOD)were detected by colorimetric method.Real-time fluorescence quantitative PCR(qRT-PCR)was used to detect the expression of miR-125a-5p.Results Compared with the H/R group,inhibition rate,apoptosis rate,Bax protein expression,LDH content and miR-125a-5p expression were decreased after low,medium and high doses of phlorizin treatment(P＜0.05),and SOD activity,Bcl-2 protein expression were increased(P＜0.05).After inhibiting the expression of miR-125a-5p,the inhibition rate,apoptosis rate,Bax protein expression and LDH content of H9C2 cells induced by H/R were decreased(P＜0.05),and SOD activity,Bcl-2 protein expression were increased(P＜0.05).Overexpression of miR-125a-5p reversed the effect of phloridin on H/R-induced proliferation,apoptosis and oxidative stress of H9C2 cells.Conclusion Phlorizin may reduce H/R-induced apoptosis and oxidative stress in H9C2 cells by decreasing the expression of miR-125a-5p.

Objective To explore the practical effect of health science popularization in public hospitals based on the"four modernizations"path.Methods Based on the science popularization practice of the theme sharing system such as"Huafu Science Popularization",and relying on the application of technologies such as big data,Internet+,and multimedia,the science popularization practice model of the"Four modernizations"path of"system institutionalization","theme classification","form diversification"and"content output precision"is created.Results The health popularization practice research of sample hospi-tals proves that many excellent science popularization works have emerged under the path of"four modernizations";Won a num-ber of provincial science popularization honors;The number of people participating in popular science competitions increased by more than 25％;1/3 and above of the offline science lecture hall are senior professional title experts of Huashan Hospital;Set up more specialized clinics;The satisfaction of characteristic outpatient patients is more than 95％.Conclusion The science popu-larization practice method based on the"Four modernizations"path has a remarkable effect on highlighting the"public welfare"function of public hospitals and improving the specialty reputation.

Objective To explore the effects of lean management practices in outpatient services based on the SMART principle in a large public hospital.Methods The outpatient quality management system was established under the SMART principle,integrating process quality management tools such as RFM model and KPI.This framework was applied to refine the outpatient treatment process,develop a quantitative evaluation program for outpatient services,and enhance patient care through-out the consultation lifecycle,from pre-consultation to post-consultation.Results The lean management practice has demonstra-ted significant outcomes in the sample hospital.There was a 32％increase in outpatient volume at the national regional medical center,rising from 286 400 to 377 200 visits in 2023.The appointment rate for specialized outpatient services increased by over 50％.The average patient waiting time was reduced from 22 minutes to 15 minutes.The medical technical examination achieved a workflow allowing for same-day registration,examination,and reporting.The laboratory's blood collection window shortened the turnaround time for routine blood reports from 60 minutes to 30 minutes.Patients now can collect outpatient medicine and re-ceive medication guidance within 8 minutes after payment.The average number of patients seen per specialist shift increased from 13 to 16.The outpatient appointment rate increased from 86％to 90％,and patient satisfaction rose from 90％to over 96％.The hospital has been consistently honored for its outpatient management in the healthcare sector.Conclusion The implementation of lean outpatient management based on the SMART principle has enhanced outpatient diagnosis and treatment efficiency,medical service quality,and patient satisfaction.It has also encouraged the hospital to maximize its potential and efficiency,contributing to the high-quality development of the hospital.

Objective:To evaluate the cervical elasticity in pregnant women with singleton pregnancies exhibiting symptoms of threatened preterm labor using E-cervix elastography, and provide a basis for assessing the risk of preterm birth.Methods:This prospective cohort study included pregnant women with singleton pregnancies between 20 +0 and 32 +6 weeks of gestation and no history of preterm birth who developed symptoms of threatened preterm labor and attended the obstetrics outpatient clinic of the Hunan Provincial Maternal and Child Health Care Hospital from May 2022 to May 2023. Several cervical elastography data, including cervical length (CL), hardness ratio (HR), internal ostium (IOS), and external ostium (EOS), were obtained using E-cervix technology, and the differences in these data were compared between women with different pregnancy outcomes (preterm or full-term birth) or different CLs. Statistical analysis was performed using covariance analysis (adjusted for gestational age), Chi-square test or corrected Chi-square test, and Pearson correlation analysis. Results:A total of 120 pregnant women were included, with 39 (32.5%) in the preterm group and 81 (67.5%) in the full-term group. There were 41 women (34.2%) with CL≤25 mm and 79 (65.8%) with CL>25 mm. Among the 41 women with CL≤25 mm, 26 had preterm birth and 15 delivered at term. Compared with the full-term group, the preterm group had a lower cervical HR [(35.75±8.94)% vs. (61.30±10.69)%, F=156.88], but higher IOS and EOS (0.47±0.13 vs. 0.31±0.09, F=54.99; 0.45±0.11 vs. 0.34±0.08, F=34.57) (all P<0.001). The patients with CL≤25 mm had a lower cervical HR [(43.17±14.32)% vs. (58.09±13.94)%, F=26.03], but higher IOS and EOS (0.46±0.14 vs. 0.32±0.08, F=38.71; 0.44±0.12 vs.0.34±0.08, F=21.36) as compared with those with CL>25 mm, with all differences being statistically significant (all P<0.001). Among the women with CL≤25 mm, preterm birth cases had lower cervical HR but higher IOS and EOS than those delivered at term (all P<0.001). In both CL≤25 mm and CL>25 mm groups, the preterm birth rate was higher in patients with HR<50% than in those with HR≥50% [95.5% (21/22) vs. 5/19, χ2=21.01, P<0.001; 61.9% (13/21) vs. 0.0% (0/58), corrected χ2=38.59, P<0.001]. Besides, an increased preterm birth rate was also observed in patients with HR<40% as compared with those with HR≥40% regardless of the CL [CL≤25 mm: 18/18 vs. 34.8% (8/23), χ2=18.51, P<0.001; CL>25 mm: 11/14 vs. 3.1% (2/65), corrected χ2=42.42, P<0.001]. Pearson correlation analysis showed that there was a significant positive correlation between CL and HR ( r=0.51, P<0.001). Conclusion:E-cervix elastography can quantify the hardness of cervical tissue, and identify truly "soft" cervices that are associated with high risk of preterm birth, showing great potential as a more efficient new technology for predicting preterm birth.

Objective Based on the support of the National Natural Science Foundation of China(NSFC)in the field of insomnia in recent 10 years,the research hotspots were analyzed in order to provide references for researchers in related field.Methods The NSFC official website,NSFC searching website,and LetPub database were comprehensively searched for insomnia related researches in recent 10 years,extract the approved year,funding type,province,supporting unit,amount of funding,subject code,key words and other informa-tion for statistical analysis and visualization.Results The funded projects were mainly general projects,the data shows a fluctuating up-ward trend and multi-disciplinary development,and new technologies and new theories emerge in an endless stream.Supporting units were mainly comprehensive and western medicine colleges and universities,and there was an unbalanced regional development.The re-searches mainly focus on the key words such as neurotransmitters,neural circuits,mechanism research,and traditional Chinese medicine diagnosis and treatment.Conclusion The funding of NSFC is of great significance in the field of insomnia and can effectively promote the development of the discipline.Future research still needs to focus on cutting-edge development,maintain the advantages of disciplines while strengthening the intersection of multi-disciplines,promote the application of new technologies and new ideas,pay attention to the transformation of achievements back-feed clinical,and effectively benefit patients.

To investigate the protective effect of 7-hydroxyethyl chrysin (7-HEC) on rats with exercise-induced fatigue in hypobaric hypoxic condition.Forty healthy male Wistar rats were randomly divided into four groups with 10 rats in each group: control group, model group, chrysin group and 7-HEC group. The rats in control group were raised at local altitude but other three groups were raised in a simulating altitude of for hypobaric hypoxia treatment. The chrysin group and 7-HEC group were given chrysin or 7-HEC by gavage for respectively; while the control group and model group were given the same amount of sterilized water. The weight-bearing swimming tests were performed 3 d later, and the weight-bearing swimming time was documented. After rats were sacrificed, the liver and skeletal muscle tissue samples were taken for pathological examination and determination of lactate, malondialdehyde (MDA), total superoxide dismutase (T-SOD) and glycogen levels. Blood urea nitrogen was also determined. Compared with the model group, weight-bearing swimming times were significantly prolonged in 7-HEC group [ vs. (4.04±1.30) min, <0.01]; pathological changes in liver and skeletal muscle tissue were attenuated; generation rate of blood urea nitrogen vs. 0.60) mmol·L·min, <0.05], lactate [liver: (0.14±0.05) vs. (0.10±0.03) mg·g·min, skeletal muscle: vs. (0.18±] and MDA [liver: (0.48) vs. (0.78±0.28) nmol·mg·min, skeletal muscle: (0.87±0.19) vs. (0.63±0.11) nmol·mg·min] were significantly reduced (all < 0.05); glycogen content [liver: (15.16±2.69) vs. skeletal muscle: (1.46±0.49) vs.0.48) mg/g] and T-SOD [liver: (1.87±0.01) vs. (2.68±0.12) U/mL, skeletal muscle: 0.42) vs. 0.96) U/mL] were significantly improved (all <0.05). 7-HEC has significant protective effect on the rats with exercise-induced fatigue in hypobaric hypoxia condition.
Altitude ; Animals ; Fatigue/prevention & control* ; Flavonoids ; Hypoxia ; Male ; Rats ; Rats, Wistar

Objective:To summarize the problems of nursing information system application in Special Ward and to explore the solutions.Methods:From January to February 2017, we summarized the problems of nursing information system application in Special Ward and analyzed the causes. From March 2017, we implemented the improvements, such as strengthening nursing training and quality control, working with doctors closely, improving the auditing ability to doctor's advice, double checking for doctor's advice, shift by words and building the ward oral drug registration. We compared the indexes of nursing quality before and after improvement.Results:After improvement, the time of daily computer operation by nurses reduced; the number of problematic doctor's advice found and corrected by nurses increased; the times of medication administration error prevention also increased; the differences were all statistical ( P<0.05) . Conclusions:Improvements for nursing information system of Special Ward effectively improve nurses' working efficiency, prevent and reduce the nursing errors.

Objective To analyze the effects of Hual qi huang granules on children with mycoplasma pneumoniae pneumonia.Methods A randomized,multicenter parallel controlled clinical trial was carried out.A total of 3 000 cases of hospitalized children with mycoplasma pneumoniae pneumonia were selected.All of them were given treatment for mycoplasma pneumoniae pneumonia with macrolide antibiotics and symptomatic treatment.They were randomly divided into 2 groups:research group and control group.The children of research group were give oral Huai qi huang granules for three months.According to the classification of pneumonia,these two groups were divided into:lobar pneumonia research group,lobar pneumonia control group,lobular pneumonia research group,lobular pneumonia control group.The hospitalization duration of fever,length of hospital stay,the absorption area of lung inflammation and pneumonia severity sores were observed.The frequency of upper respiratory infections,bronchitis,pneumonia were observed in 3 months after discharge.Results 2 378 cases were investigated.The hospitalization duration of fever,length of hospital stay of research group were significantly shorter than that of in control group (P ＜ 0.001).The children with lobar pneumonia,2 weeks after treatment,the absorption of consolidation of the lobar pneumonia research group is significantly better than lobar pneumonia control group (P ＜0.001).After two weeks treatment,the pneumonia scores of lobar pneumonia research group is lower than lobar pneumonia control group (P ＜ 0.05).Followup of 3 months after hospital discharge,frequency of upper respiratory infection and bronchitis of research group,were significantly lower than that of control.In addition,appetite increased significantly in research group than control (P ＜ 0.001).There are 21 cases with drug associated adverse reactions (mild diarrhea),including 12 cases of research group,9 cases of control group,and there was no statistical significance (P ＞0.05).Conclusion Standard treatment combined with oral Huai qi huang granules in the treatment of mycoplasma pneumoniae pneumonia,can significantly shorten hospitalization duration of fever,length of hospital stay and reduce the severity score of pneumonia.Three months oral Huai qi huang granules can significant reduce the frequency of respiratory infections and bronchitis,also can increase patients appetite,and be safe.