Hand hygiene is the most basic,simplest,and most effective measure to reduce nosocomial infections. Most disinfectants used in medical institutions adopt manually press. Frequent contact between contaminated hands of medical staffs and the pressed part,the compliance that do not meet the standard for hand hygiene,and non-quantitative use of disinfectants are all risk factors for nosocomial infections,which also are key points and difficulties of controlling infection in hospital. This study designed a suction device for disinfectant bottles,which consisted of a dispenser body,an electric pump,an infrared sensor circuit control board,and a power supply module. It can realize the functions include non-contact,quantitative dispensing of disinfectants,and voice broadcast prompt of hand hygiene,which can reduce the risk and incidence of cross-infection,and avoid inadequate disinfection for hands due to too little disinfectant,or waste of too much disinfectant. At the same time,it is important to strengthen relevant knowledge of hand hygiene,and to improve the compliance and correctness of medical staffs for hand hygiene.

Hand hygiene is the most basic,simplest,and most effective measure to reduce nosocomial infections. Most disinfectants used in medical institutions adopt manually press. Frequent contact between contaminated hands of medical staffs and the pressed part,the compliance that do not meet the standard for hand hygiene,and non-quantitative use of disinfectants are all risk factors for nosocomial infections,which also are key points and difficulties of controlling infection in hospital. This study designed a suction device for disinfectant bottles,which consisted of a dispenser body,an electric pump,an infrared sensor circuit control board,and a power supply module. It can realize the functions include non-contact,quantitative dispensing of disinfectants,and voice broadcast prompt of hand hygiene,which can reduce the risk and incidence of cross-infection,and avoid inadequate disinfection for hands due to too little disinfectant,or waste of too much disinfectant. At the same time,it is important to strengthen relevant knowledge of hand hygiene,and to improve the compliance and correctness of medical staffs for hand hygiene.

The problem of drug resistance resulting from the long-term use of antimicrobials is a serious threat to global health,and the emergence of multidrug-resistant bacteria,in particular,has greatly limited therapeutic op-tions.Therefore,the development of new or alternative antimicrobial agents has become an urgent need.Antimi-crobial peptides(AMPs)have been regarded as good alternatives to antibacterial drugs due to their strong antibac-terial activity and unique mechanism of action.At present,some AMPs have completed preclinical studies on drug-resistant bacterial infections and entered the clinical trial stage,while their stability and targeting have been signifi-cantly improved through the optimisation of amino acid modification,nano-delivery system and other technolo-gies,which have gradually become a research hotspot in this field.Therefore,this paper discusses the importance of AMPs in bacterial drug resistance from the biological properties of AMPs,the mechanism of regulating bacteri-al drug resistance and the application of AMPs in the treatment of drug-resistant bacterial infections,with a view to providing a reference for the development of drugs against drug-resistant bacteria and clinical application.

The problem of drug resistance resulting from the long-term use of antimicrobials is a serious threat to global health,and the emergence of multidrug-resistant bacteria,in particular,has greatly limited therapeutic op-tions.Therefore,the development of new or alternative antimicrobial agents has become an urgent need.Antimi-crobial peptides(AMPs)have been regarded as good alternatives to antibacterial drugs due to their strong antibac-terial activity and unique mechanism of action.At present,some AMPs have completed preclinical studies on drug-resistant bacterial infections and entered the clinical trial stage,while their stability and targeting have been signifi-cantly improved through the optimisation of amino acid modification,nano-delivery system and other technolo-gies,which have gradually become a research hotspot in this field.Therefore,this paper discusses the importance of AMPs in bacterial drug resistance from the biological properties of AMPs,the mechanism of regulating bacteri-al drug resistance and the application of AMPs in the treatment of drug-resistant bacterial infections,with a view to providing a reference for the development of drugs against drug-resistant bacteria and clinical application.

Discipline construction is the main focus of the high-quality development of public hospitals. The authors elaborated on the practice of Zhongshan Hospital(Xiamen), Fudan University, based on the " double-center" homogenization management, implementing the 123456 strategy of " integrated management and homogeneous development" in discipline construction. The hospital has promoted discipline construction from six aspects: building discipline cluster, promoting talent cultivation, building science and technology innovation platform, precise personnel classification, medical and education collaborative education, and information sharing and support. It has achieved new development goals of filling weak discipline gaps, transforming talent transfusion into hematopoietic, and integrating medical, educational, research and management innovation. However, it also encountered difficulties such as homogenization barrier of discipline construction, shortage of excellent talents, and limited brand influence of superior disciplines. The authors put forward suggestions from three dimensions: deepening homogeneous management, building talent echelon, and increasing publicity, in order to provide experience for the high-quality development of other hospitals.

OBJECTIVE To confirm the therapeutic effect of Jintiange capsules on osteoarthritis(OA) and the potential mechanism of synovial mesenchymal stem cell exosomes(SMSC-Exos) and articular chondrocytes(ACs) in the treatment of OA based on high-throughput sequencing technology. METHODS Type Ⅱ collagenase-induced OA rats were used for efficacy verification through general behavioral observation, bipedal balance difference experiment, mechanical foot reflex threshold, Micro-CT observation, and Safranin O-Fast Green staining. SMSCs and ACs were cultured in suitable concentration of drug-containing serum, and mRNA sequencing was performed on ACs in the control, model, and Jintiange capsules groups, as well as miRNA sequencing on SMSC-Exos. Differential expressed mRNAs and miRNAs were screened and target genes were predicted. The common differential expressed genes between SMSC and ACs were obtained by intersecting the differential expressed genes, and a miRNA-mRNA regulatory network was constructed using Cytoscape software. The expression trend analysis of common differential expressed genes was conducted, as well as the correlation analysis between differential expressed gene mRNA and miRNA, Micro-CT efficacy indicators, and differential expressed gene mRNA. RESULTS Under the pathological state of OA, the expression of miRNA-23a-3p, miRNA-342-3p, miRNA-146b-5p, miRNA-501-3p, and miRNA-214-3p were down-regulated, while miRNA-222-3p, miRNA-30e-3p, miRNA-676-3p, and miRNA-192-5p were up-regulated (P<0.05). The expressions of these miRNAs were significantly reversed after intervention with drug-containing serum of Jintiange capsules. There was a certain correlation between Micro-CT efficacy indicators, mRNA and miRNA. CONCLUSION Jintiange capsule has obvious efficacy in the treatment of OA, and its mechanism may be related to the promotion of SMSC-Exos targeting ACs to transport miRNA and then regulate Serpinb10, Ntn1, Il1b, Tgm2, Megf10, Il11, Cd40, Slc15a3, Pou2f2 and other genes.

Objective:To explore the effect of paeoniflorin on LPS-induced bronchial epithelial cell inflammatory response by regulating NF-κB pathway.Methods:BEAS-2B cells were cultured in vitro for paeoniflorin toxicity assay and concentration screening.BEAS-2B cells were divided into control group,LPS group,LPS+CAPE group,LPS+PF group and LPS+CAPE+PF group.Inflammatory responses were induced in BEAS-2B cells using LPS(1 μg/ml),and cell viability was detected by CCK-8 assay after administration of paeoniflorin or CAPE interventions.Apoptosis and cell cycle were detected by flow cytometry.The levels of IFN-γ,IL-4,IL-17C and IL-10 were detected by ELISA.The protein expression levels of p53,Bcl-2,Bax,Cyclin1,NF-κB and p-p65 were detected by Western blot.Results:Paeoniflorin increased cell viability,inhibited apoptosis,increased IFN-γ and IL-10 levels(P<0.01),de-creased IL-4 and IL-17C levels(P<0.01),down-regulated the protein expression levels of p53,Bax,NF-κB and p-p65(P<0.01),and up-regulated the protein expression levels of Bcl-2 and Cyclin1(P<0.01).The effect of paeoniflorin was more significant after the intervention of NF-κB inhibitor CAPE.Conclusion:Paeoniflorin reduces LPS-induced inflammatory factor levels in bronchial epithelial cells by regulating the NF-κB pathway,thereby suppressing the asthmatic inflammatory response.

Objective : To explore the epicardial adipose tissue ( EAT) of patients with coronary heart disease , KLF7 stimulates macrophages to secrete inflammatory factors and promotes the differentiation and maturation of adipocytes through the NF⁃κB signaling pathway , and to clarify the mechanism of KLF7 in the occurrence and development of CAD. Methods : 30 patients with coronary heart disease ( CAD group) and 30 patients without coronary heart disease (non⁃CAD group) were collected , and general data and biochemical indicators were collected. qRT⁃PCR was used to detect the expression levels of KLF7 , APN , IL⁃6 , and TNF⁃α mRNA in EAT. Human THP⁃1 cells were cultured in vitro and induced into M1 type macrophages and 3T3 ⁃L1 preadipocytes. The cells were divied into 3 groups : KLF7 up⁃regulated group ( transfected with KLF7 mimic) , KLF7 down⁃regulated group ( transfected with siRNA knockdown KLF7 ) , NC group ( transfected oligopeptide sequence) , transfected two kinds of cells. qRT⁃PCR was used to detect the expression of APN , MCP⁃1 , IL⁃6 and TNF⁃α mRNA in M1 type macrophages , and the protein expression levels of key factors in the NF⁃κB signaling pathway were detected by Westren blot. The qRT⁃PCR method was used to detect APN , KLF4 , IL⁃6 , MCP⁃1 mRNA and adipocyte differentiation marker peroxisome proliferator⁃activated receptor⁃γ (PPARγ) in 3T3 ⁃L1 preadipocytes 24 h after transfection. CCAAT/enhancer binding protein α (C/EBPα ) , fatty acid binding protein 4 (FABP4) mRNA relative expression levels , and Westren blot was used to detect protein expression levels. Results : Compared with the non⁃CAD group , the expression of CAD group decreased , APN decreased , IL⁃6 and TNF⁃α increased significantly , and the difference was statistically significant (P < 0. 01) . KLF7 was highly expressed in human THP⁃1 derived M1 macrophages induced by inflammatory stimuli (LPS) . In M1 macrophages derived from human THP⁃1 , knocking down KLF7 could inhibit the release of inflammatory factors. Transfection with KLF7 ⁃siRNA could significantly inhibit LPS⁃induced phosphorylation of JNK⁃MAPKs , the level of p⁃p65 and the activation of p ⁃IκBa (P < 0. 05) . In 3T3 ⁃L1 preadipocytes , upregulation of KLF7 increased the expression of adipocyte differentiation markers PPARγ , C/EBPa , FABP4 mRNA , and promoted the differentiation of 3T3 ⁃L1 preadipocytes into adipocytes (P < 0. 05) . Conclusion The expression of KLF7 in EAT in CAD patients increases. KLF7 activates the activation of macrophages mediated by the JNK⁃NF⁃KB signaling pathway in EAT , promotes inflammation in EAT in CAD patients , and promotes the differentiation and maturation of adipocytes , thereby promoting the development of CAD. It indicates that KLF7 may be a potential therapeutic target for cardiovascular diseases (such as CAD) .

In recent years, the problem of bacterial resistance has become more and more serious, which has brought troubles to global public health and medical care. The time and money required to develop new antibiotics is even greater than before. Bacteriophage is a kind of virus that can specifically infect bacteria, fungi, actinomycetes and other microorganisms. Relying on host bacteria to replicate in large numbers, rich species, low research and development cost, the value of anti-infection therapy is very considerable. It is a new generation of biological antimicrobial agents with great potential. This paper briefly describes the sterilization mechanism, progress of research on anti-infection aspect and clinical application of phage, in order to provide reference for phage anti-infection treatment and clinical application.

In response to calls of the state to share high quality medical resources with the primary levels for easier access of the local people to best medical care instead of pouring into tertiary hospitals in metropolitans, Xiamen city joined hands with Zhongshan Hospital of Fudan University to establish Xiamen Hospital affiliated to Zhongshan Hospital of Fudan University in an innovative model of " city-university cooperation and homogeneous management" . Open for full service in January 2018, the hospital is run by Zhongshan Hospital in a closed-type medical alliance, enjoying homogenous management in terms of administrative framework, quality of care, talent training and IT management. Thanks to this practice, the hospital has grown into one of the first pilot units of the national regional medical center program, rapidly upgrading medical service level of Xiamen city and its surrounding regions. This paper highlighted the practice of homogeneous management, and analyzed the challenges and solutions for references of building trans-regional closed-type medical alliances.