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.

In this experiment, the PK/PD fitting model of Chuanxiong(Chuanxiong Rhizoma) in the treatment of rheumatoid arthritis was established in the form of acupoint combined with external application gel paste. Firstly, the rheumatoid arthritis model was induced by ovalbumin, and the articular fluid of rabbits was extracted by microdialysis. The pharmacokinetic process of Chuanxiong in rabbit articular fluid was analyzed by UPLC-MS/MS, and the pharmacokinetic model was established. The pharmacodynamic effects of Chuanxiong on inflammatory factors IL-1β, TNF-α, and IL-6 were analyzed by enzyme-linked immunosorbent assay(ELISA). The pharmacodynamic model was established, and the PK/PD model was obtained by fitting the data of pharmacokinetics and pharmacodynamics. The results of pharmacokinetics showed that the concentration of ligustrolide A in the articular cavity by drug administration on classical acupoint Zusanli(ST 36) was higher than that by Yanglingquan(GB 34), which reflected the advantage of typical acupoint, while ligustrazine concentration was higher after administration through Yanglingquan than through Zusanli, which was different from the traditional acupoint theory. The results of pharmacodynamics showed that the drug had lag effect. The PK/PD model was constructed by fitting the data. When IL-1β was taken as the efficacy index, the PK/PD models of Chuanxiong in typical acupoint Zusanli group, atypical acupoint Yanglingquan group, and non-acupoint group were E=115.28C_e/(3 316.72+C_e), E=108.73C_e/(2 993.47+C_e), and E=101.34C_e/(3 028.51+C_e). When TNF-α was taken as the efficacy index, the PK/PD models of Chuanxiong in typical acupoint Zusanli group, atypical acupoint Yanglingquan group, and non-acupoint group were E=68.31C_e/(3 285.16+C_e), E=59.27C_e/(2 919.86+C_e), and E=53.61C_e/(2 862.87+C_e). When IL-6 was taken as the efficacy index, the PK/PD models of Chuanxiong in typical acupoint Zusanli group, atypical acupoint Yanglingquan group, and non-acupoint group were E=59.92C_e/(3 461.17+C_e), E=58.34C_e/(2 723.51+C_e), and E=49.17C_e/(2 862.76+C_e). The parameters showed that there were significant differences in E_(max), EC_(e50) and k_(eo). The analysis of data found that the PK/PD fitting effect of Zusanli, a typical acupoint, was the best, which proved that it was still the best site for drug administration. To sum up, it shows that there may be bidirectional selectivity between drugs and acupoints.
Animals ; Rabbits ; Tumor Necrosis Factor-alpha ; Chromatography, Liquid ; Interleukin-6 ; Tandem Mass Spectrometry ; Acupuncture Points ; Arthritis, Rheumatoid/drug therapy*

【Objective】 To study the protective effect of glycine solution on frozen red blood cell thawing process. 【Methods】 A total of 20 bags of 1 U of leukocytes reduced suspended red blood cells within 6 days were selected for the study. After mixing, each 2 bags of suspended red blood cells were divided into 2 bags and into two groups with 10 bags of 1 U in each group, and were frozen for storage. One group was deglycerolized with sodium chloride solution (control group), and one group was deglycerolized with glycine solution (experimental group). The hemoglobin, free hemoglobin, residual glycerol, total glycerol in red blood cells, adenosine triphosphate (ATP) and 2,3-diphosphoglycerate (2,3-DPG) were detected in the two groups. 【Results】 Compared with the free hemoglobin content (0.90±0.05)g/L and residual glycerol content (1.17± 0.08)g/L in the control group, the final product red blood cell supernatant free hemoglobin content (0.77±0.15)g/L and residual glycerol content (0.79±0.33)g/L in the experimental group were decreased, and the difference was statistically significant (P<0.05). Compared with the ATP content (4.03±0.38)µmol/gHb and 2,3-DPG content (485.65±78.08)µg/L in the control group, the ATP content (4.41±0.35)µmol/gHb and 2,3-DPG content (656.28±116.68)µ g/L in the experimental group were significantly increased, with statistical significance (P<0.05). 【Conclusion】 Using glycine solution instead of sodium chloride solution to prepare frozen thawed deglycerolized erythrocytes achieved the effect of protecting erythrocytes, reduced the hemolysis rate of erythrocytes and glycerin residue, and increased the recovery rate of erythrocytes.

Objective: To investigate the association between blood pressure and all-cause mortality in Shanxi, China. Methods: The '2002 China Nutrition and Health Survey' baseline data in Shanxi province was used. A retrospective investigation was performed in 2015. The effects of SBP and DBP on the all-cause mortality were analyzed using the Cox regression model. The hazard ratio ( Results: The follow-up rate was 76.52% over 13 years, while the cumulative mortality rate for all participants was 917.12/100,000 person-years. The mortality rose with an increasing SBP ( Conclusion Adults with SBP > 160 mmHg and DBP > 100 mmHg had a higher mortality risk. Sex and age difference was noted in both DBP and mortality risk.
Adolescent ; Adult ; Aged ; Blood Pressure ; China ; Cohort Studies ; Female ; Health Surveys ; Humans ; Hypertension/mortality* ; Male ; Middle Aged ; Mortality/trends* ; Proportional Hazards Models ; Young Adult

【Objective】 To explore the effect of bisoprolol on ICa，Lin volume overload combined with pressure overload heart failure in rabbits. 【Methods】 Totally 82 male New Zealand rabbits （2.5-3.0 kg） were randomly divided into three groups： SO （sham group）， HF （heart failure group）， and BF （heart failure with bisoprolol treatment group）. HF rabbits were duplicated by aortic valve insufficiency procedure combined with abdominal aorta constriction procedure. Real-time PCR and Western blot analysis were performed to detect the expression of ICa，L in left ventricular myocytes. Left ventricular myocytes were isolated； then the cell membrane capacitance， the current density， activation and inactivation of ICa，L were recorded by whole cell patch clamp. 【Results】 ① Bisoprolol could improve the heart function of heart failure rabbits according to the measurement of echocardiography and BNP. ② The expressions of ICa，L mRNA and protein decreased significantly in heart failing rabbits （P<0.01）， but remained unaltered after chronic bisoprolol treatment （P>0.05）. ③ Membrane capacitance was larger in heart failing groups than in sham group （P<0.01）. ICa，L current density decreased greatly in HF group （P<0.01）. Bisoprolol treatment could not change Cm or ICa，L density （P>0.05）. V1/2 of activation curve negative shift enlarged window currents in heart failure groups. Bisoprolol treatment caused window currents to decrease. 【Conclusion】 Bisoprolol could reverse the heart function of heart failure rabbits and also affect the function of ICa，L.

Adolescent ; Child ; China/epidemiology* ; Humans ; Malnutrition ; Nutritional Status ; Prevalence

Objective: To estimate the burden of cirrhosis and other chronic liver diseases caused by specific etiologies in China. Methods: Data from the Global Burden of Disease Study 2016 (GBD 2016) were used. We evaluated the burden by analyzing age-sex-province-specific prevalence, mortality, and disability-adjusted life-years (DALYs) of 33 provinces in China. Results: From 1990 to 2016, prevalence cases in thousands increased by 73.7% from 6833.3 (95% : 6498.0-7180.6) to 11869.6 (95% : 11274.6-12504.7). Age-standardized mortality and DALY rates per 100,000 decreased by 51.2% and 53.3%, respectively. Male and elderly people (aged ≥ 60 years) preponderance were found for prevalence, mortality, and DALYs. The number of prevalence cases, deaths, and DALYs due to hepatitis C virus (HCV) increased by 86.6%, 8.7%, and 0.9%, respectively. Also, age-standardized prevalence rates decreased in 31 provinces, but increased in Yunnan and Shandong. The Socio-demographic Index (SDI) values were negatively correlated with age-standardized mortality and DALY rates by provinces in 2016; the correlation coefficients were -0.817 and -0.828, respectively. Conclusion Cirrhosis and other chronic liver diseases remain a huge health burden in China, with the increase of population and the aging of population. Hepatitis B virus (HBV) remains the leading cause of the health burden in China.

OBJECTIVE: To establise the bank of platelet donors with the human platelet antigen (HPA) 1-6, 15 genes so as to provide the HPA-matched platelets for the patients. METHODS: The HPA genotyping of platelets donors and patients with platelet antibody positive confirmed by sercening was performed by using the SSP-PCR; the efficacy of transfusing the HPA-matched platelets for 37 cases platelet antibody positive was analyzed. RESULTS: The most common genotype in platelet donors were HPA-1a/1a-2a/2a-3a/3b-4a/4a-5a/5a-6a/6a-15a/15b, followed by HPA-1a/1a-2a/2a-3a/3a-4a/4a-5a/5a-6a/6a-15a/15b; the most common genotype in 53 cases of platelet antibody positive confirened by screening were HPA-1a/1a-2a/2a-3a/3b-4a/4a-5a/5a-6a/6a-15a/15b. Among 37 patients with platelet antibody positive confirened by screeming, 28 showed that the transfusion of HPA-matched platelets was effective with statistically significant difference in comparison with random transfusion group. The HPA-3, HPA-15 were the main factors leading to polymorphisms. CONCLUSION HPA-3 and HPA-15 are polymorphic, which should be focused on. HPA-matched platelets can improve the efficiency of platelet transfusion, and avoid the waste of blood resources. The genotypes of platelet donors can basically meet the requirements for common genotype transfusion.

Postmortem interval （PMI） estimation has always been an important and difficult issue in the field of forensic pathology. In recent years, research progress on the estimation of PMI using RNA specific variation patterns after death has been made by researchers at home and aboard. This paper summarizes the specific application methods of messenger RNA and non-coding RNA for PMI estimation based on the literatures and discusses the existing problems and development trends, in order to provide technical reference for related studies and estimation practice.
Autopsy ; Forensic Pathology ; Humans ; Postmortem Changes ; RNA, Messenger/genetics* ; RNA, Untranslated ; Time Factors

Objective: This study aimed to assess the association of waist circumference (WC) with all-cause mortality among Chinese adults. Methods: The baseline data were from Shanxi Province of 2002 China Nutrition and Health Survey. The death investigation and follow-up visit were conducted from December 2015 to March 2016. The visits covered up to 5,360 of 7,007 participants, representing a response rate of 76.5%. The Cox regression model and floating absolute risk were used to estimate hazard ratio and 95% floating of death by gender and age groups (≥ 60 and < 60 years old). Sensitivity analysis was performed by excluding current smokers; participants with stroke, hypertension, and diabetes; participants who accidentally died; and participants who died during the first 2 years of follow-up. Results: This study followed 67,129 person-years for 12.5 years on average, including 615 deaths. The mortality density was 916 per 100,000 person-years. Low WC was associated with all-cause mortality among men. Multifactor-adjusted hazard ratios ( ) were 1.60 (1.35-1.90) for WC < 75.0 cm and 1.40 (1.11-1.76) for WC ranging from 75.0 cm to 79.9 cm. Low WC (< 70.0 cm and 70.0-74.9 cm) and high WC (≥ 95.0 cm) groups had a high risk of mortality among women. The adjusted s of death were 1.43 (1.11-1.83), 1.39 (1.05-1.84), and 1.91 (1.13-3.22). Conclusion WC was an important predictor of death independent of body mass index (BMI). WC should be used as a simple rapid screening and predictive indicator of the risk of death.
Adult ; Age Factors ; Aged ; Aged, 80 and over ; China ; epidemiology ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mortality ; Obesity, Abdominal ; complications ; epidemiology ; etiology ; Risk Factors ; Sex Factors ; Waist Circumference ; Young Adult