Objective To investigate the current status of infection management quality control centers in county-level hospitals in Guangdong Province,providing reference for the development of quality control management programs for county-level infection control centers by provincial infection control centers,and exploring corresponding management strategies.Methods A survey was conducted using the QuestionStar questionnaire platform to investigate county-level quality control centers established in Guangdong Province before December 31,2023.The survey covered the establishment time,personnel structure,level of in-formatization,management,quality control,and training of hospital infection management professional quality control centers.Results There are 68 county-level infection control centers in Guangdong Province,with a coverage rate of 50.37%,and 95.59%of them have been established within the past five years.Experts mainly come from clinical and nursing backgrounds(accounting for23.75%and62.97%respectively),and the majority have a bachelor's degree(71.06%).Only 13%have operational funding.Among them,39 have established hospital infection informatization monitoring,23 have not been equipped,and 6 are under construction.Twenty centers have conducted quality control supervision and issued quality control reports,ac-counting for 29.41%,while 41 have organized training,accounting for 60.29%.Conclusion The coverage rate of county-level infection management quality control centers in Guangdong Province is steadily increasing,but not all counties and districts are covered.There is a lack of policy and funding support,insufficient personnel allocation,and inadequate professional coverage.The health administrative departments and county-level infection control centers need to unify monitoring standards,quality con-trol specifications,and evaluation programs,improve infection control capabilities,and enhance the"four-level"management and training system to effectively promote the quality and safety management level of primary healthcare institutions.

The awake prone position plays an important role in the treatment of hypoxemia and the improvement of respiratory distress symptoms in non-intubated patients. It is widely used in clinical practice because of its simple operation, safety, and economy. To enable clinical medical staff to scientifically and normatively implement prone position for awake patients without intubation, the committees of consensus formulation, guided by evidence-based methodology and Delphi method, conducted literature search, literature quality evaluation and evidence synthesis around seven topics, including indications and contraindications, evaluation, implementation, monitoring and safety management, termination time, complication prevention and health education of awake prone position. After two rounds of expert letter consultation, Expert consensus on implementation strategy of awake prone positioning for non-intubated patients in China (2023) was formulated, and provide guidance for clinical medical staff.
Humans ; Consensus ; Prone Position ; Wakefulness ; China ; Dyspnea

Objective To compare the clinical efficacy of aescuven fort and indomethacin in the prevention of heterotopic ossification (HO) after operative treatment of radial head fractures with anterior bundle of medial collateral ligament(AMCL) injury.Methods A total of 41 patients with radial head fracture combined with AMCL injury leading to elbow valgus instability were randomly divided into 21 cases of the observation group(aescuven fort) and the 20 cases of control group(indomethacin),and were treated with aescuven fort of 600rng/d and indomethacin of 75rng/d for 6 weeks respectively.The incidence of adverse reactions of gastrointestinal tract in the two groups was statistically analyzed,and symptomatic treatment was given.Six weeks later,the incidence of HO was recorded by X-ray examination of the elbow joint.The range of motion (ROM) was recorded,and the excellent and good rate of the improved HSS score was calculated.The results were statistically analyzed.Results The incidence rates of gastrointestinal side effects in the observation group and control group were 9.5％ and 35.0％,respectively,and the difference was statistically significant between the two groups(x2 =4.651,P =0.027).The incidence rate of HO in the observation groupwas 14.3％,which in the control group was 15.0％,there was no significant difference between the two groups(x2 =0.206,P =0.948).The ROM and excellent and good rate of the improved HSS score in the observation group and control group were [(119.2 ± 19.7) ° and 86.9％]and [(120.8 ± 16.3) ° and 88.7％],respectively,and the differences were statistically significant(t =2.023,P=0.613;x2 =0.176,P =0.675).Conclusion Aescuven fort can effectively prevent the formation of HO after operative treatment of radial head fracture with AMCL injury,similar with indomethacin.But the incidence rate of gastrointestinal side effects of aescuven fort is significantly lower than indomethacin.

Objective To investigate and analyze the risk factors of pressure ulcer in geriatric hospitalized patients in neurology department and related nursing intervention.Methods The date of 100 geriatric hospitalized patients in neurology department was retrospectively analyzed.The age,nutritional status,complications,correlated factors of medical equipments (indwelling gastric tube,urinary catheter,PICC tube,trachea intubation,ventilator tube,and electrocardiogram monitor) and Norton scale scores were evaluated.Fifty-one patients from February to December 2015 were enrolled in control group,and 49 patients from January to September 2016 were included in observation group,The control group used conventional care,while the observation group developed management processes by the pressure ulcer monitoring management team,and nurses were give personalized and predictive care measures after pressure ulcer knowledge training.The Norton scale scores,incidence rates of pressure ulcer and patients'satisfaction were compared between the two groups.Results Senile dementia,related factors of medical equipments,low BMI and anemia were independent risk factors for elderly patients with pressure ulcers.The Norton scores and incidence of pressure ulcer of the observation group were significantly lower,and satisfaction of the patients and their families was significantly higher than that of the control group (P ＜ 0.05).Conclusion Senile dementia,related factors of medical equipments,low BMI and anemia are independent risk factors of elderly patients with pressure ulcer.Monitoring and predictive care measures can effectively reduce the risk and the incidence of pressure ulcers of patients and improve satisfaction for geriatric neurology pressure ulcers in patients.

Objective To investigate and analyze the risk factors of pressure ulcer in geriatric hospitalized patients in neurology department and related nursing intervention.Methods The date of 100 geriatric hospitalized patients in neurology department was retrospectively analyzed.The age,nutritional status,complications,correlated factors of medical equipments (indwelling gastric tube,urinary catheter,PICC tube,trachea intubation,ventilator tube,and electrocardiogram monitor) and Norton scale scores were evaluated.Fifty-one patients from February to December 2015 were enrolled in control group,and 49 patients from January to September 2016 were included in observation group,The control group used conventional care,while the observation group developed management processes by the pressure ulcer monitoring management team,and nurses were give personalized and predictive care measures after pressure ulcer knowledge training.The Norton scale scores,incidence rates of pressure ulcer and patients'satisfaction were compared between the two groups.Results Senile dementia,related factors of medical equipments,low BMI and anemia were independent risk factors for elderly patients with pressure ulcers.The Norton scores and incidence of pressure ulcer of the observation group were significantly lower,and satisfaction of the patients and their families was significantly higher than that of the control group (P ＜ 0.05).Conclusion Senile dementia,related factors of medical equipments,low BMI and anemia are independent risk factors of elderly patients with pressure ulcer.Monitoring and predictive care measures can effectively reduce the risk and the incidence of pressure ulcers of patients and improve satisfaction for geriatric neurology pressure ulcers in patients.

Objective To investigate the effect of triptolide (TP) on proliferation and apoptosis of cyst-lining epithelial cells with autosomal dominant polycystic kidney disease ( ADPKD). Methods Primary cultured cyst-lining epithelial cells were treated with TP at different concentrations for 12 h,24 h,48 h and 72 h, respectively.The proliferation activity of the cells was evaluated by Brdu assay. The cell cycle distribution was determined by flow cytometry. The apoptotic and apoptotic ratio were determined by FITC-AnnexinV binding/ PI. The morphological changes of cyst-lining epithelial cells were observed under transmission electron microscope. Results TP significantly inhibited the proliferation of cyst-lining epithelial cells and induced apoptosis in a dose- (10-40 ng?mL-1 )and time-dependent(12-48 h) manner. Typical ultrastructural changes of apoptotic cells were observed under electron microscope. Conclusion TP significantly inhibited the proliferation of cyst-lining epithelial cells and induced the apoptosis of cyst-lining epithelial cells, thus inhibited cyst forming and delayed cyst developing. The mechanism may involve several targets and pathways.

Objective To evaluate the diagnostic accuracy of 4 μg/mL vancomycin screening plate (4VA)for vancomycin-non-susceptible Staphylococcus aureus.Methods The diagnosis trials on 4VA for vancomycin-non-susceptible Staphylococcus aureus were searched in the databases such as PubMed(1 966 to Aug.2013),The Cochrane Library(the second phase of 2013),ISI Web of Knowledge(1 980 to Aug.2013),CNKI (1 964 to Aug.2013),VIP (1 989 to Aug.2013)and Wanfang(1 998 to Aug.2013),mean-while the manual.Two reviewers evaluated the quality of the included trials according to the quality assessment of diagnostic accu-racy studies,and then meta-analysis was performed using Meta-Disc 1.4 software.Results A total of 3 trials involving 974 partici-pants were included.The results of meta-analysis showed that the weighted sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and diagnostic odds ratio,were 0.805 [95%CI (0.047 to 0.563)],0.921 [95%CI (0.901 to 0.938)],10.804 [95%CI (5.5 1 1 to 21.181)],0.1 62 [95%CI (0.71 to 1.0)]and 69.721 [95%CI (1 1.740 to 414.06)]respectively.Conclusion 4VA for vancomycin-non-susceptible Staphylococcus aureus has a very high specificity and sensitivity,so 4VA could be used to creening plate (4VA)for vancomycin-non-susceptible Staphylococcus aureus in clinic.

This study was aimed to optimize the extraction process of hyperoside from leaves ofAcanthopanax senticosusby compounding-enzyme method and orthogonal experiment. The hyperoside compound was regarded as standard and determined by HPLC. Based on the experiments of 4 factors including the enzyme amount, temperature, extraction time and PH values, the extraction process of hyperoside was determined by the orthogonal experiments and variance analysis. The results of single-factor experiments showed that different enzymes showed different effects on the enhance yield of hyperoside. The effects of different factors showed that the order of PH, neutral protease, temperature, time, pectinase, xylanase and cellulose was from strong to weak. Through orthogonal analysis, the optimum conditions were 2% pectinase, 2% xylanase, 0.5% neutral protease, and 0.5% cellulose, under the temperature of 30°C, extraction time of 10 min, and pH = 4.5. Under these conditions, the extraction rate was 1.84%. The yield was increased 107% compared with traditional process. It was concluded that the use of compounding enzyme can increase the yield of hyperoside, which possessed a lot of economic benefits.

Objective To investigate the effects of Acanthopanax Senticosus Injection (ASI) on free radical metabolism and apoptosis in the hepatic tissue after hepatic ischemia-reperfusion in rats.Methods A total of 100 rats were randomly divided into 5 groups: a sham operation group, a model group, and groups of high-, medium- and low-dose ASI, 20 rats in each group. Seven days before modeling, the drugs had been given by intraperitoneal injection. The rats in the high-, medium- and low-dose groups were given ASI 40, 80 and 120 mg/kg, respectively, and the rats in the sham operation and model groups were given equivalent volume of normal saline. A rat model of hepatic ischemia reperfusion was induced by partial hepatic pedicle clamping followed by reperfusion. 2 h after reperfusion, the activities of SOD, GSH-Px, GST and the MDA level in the hepatic tissue were determined; the activities of ALT and AST in serum were also determined; the histopathological changes and hepatocyte apoptosis were observed using the HE staining and the TUNEL staining, respectively.Results In comparison with the model group, the activities of SOD (11.16 ± 2.31 U/mg, 10.63 ± 1.92 U/mgvs.7.34 ± 1.78 U/mg;P<0.01 orP<0.05), GSH-Px (15.48 ± 2..91 U/mg, 13.23 ± 1.87 U/mgvs. 10.35 ± 2.04 U/mg;P<0.01 orP<0.05), GST(1.76 ± 0.25 U/mg, 1.55 ± 0.22 U/mgvs.0.94 ± 0.18 U/mg;P<0.01 orP<0.05) in the hepatic tissue in the ASI high- and medium-dose groups were significantly increased; and the MDA level in the hepatic tissue significantly decreased (4.67 ± 1.24 nmol/mg, 4.93 ± 1.53 nmol/mgvs.10.29 ± 2.41 nmol/mg); the serum levels of ALT(671.82 ± 338.37 U/L, 803.91 ± 441.63 U/Lvs.1 416.22 ± 538.94 U/L;P<0.01 orP<0.05), AST(329.02 ± 161.88 U/L, 417.26 ± 182.37 U/Lvs.751.93 ± 262.75 U/L;P<0.01 or P<0.05) were significantly decreased; the histopathological changes and hepatocyte apoptosis in the ASI high-, medium - and low-dose groups were significantly reduced.Conclusions ASI could effectively attenuate oxidative stress in the, improve the histopathological changes, inhibit hepatocyte apoptosis, and protect against hepatic ischemia reperfusion injury in rats.

Objective To investigate the possible role and significance of soluble programmed death-1 (sPD-1)/soluble programmed death ligand 1 (sPD-L1) in the pathogenesis of oral lichen planus(OLP).Methods Thirty-six patients with OLP(20 cases of reticular OLP and 16 cases of erosive OLP) were enrolled in this study,and 18 healthy people served as controls.Lymphocyte subsets(CD3+,CD4+,CD8+,CD19+,CD16++56+) were examined by flow cytometric analysis and humoral immunity indexes(IgG,IgA,IgM,C3,C4) tested by nephelometry immunoassay.The levels of sPD-1 and sPD-L1 proteins in serum of patients with OLP were determined by enzyme-linked immunosorbent assay.The correlations between the level of sPD-1,sPD-L1 proteins and the immune status and clinical characteristics of patients with OLP were analyzed by SPSS 19.0.Results CD3+,CD4+,CD8+,CD16++56+ in patients with OLP were decreased compared with the normal value,while CD19+ in patients with OLP was increased compared with the normal value(P＜0.05).C3 and C4 in patients with OLP were decreased compared with the normal value,but IgM in patients with OLP was increased(P＜0.05).The levels of sPD-1 and sPD-L1 proteins in patients with OLP were significantly higher than that in control group[26.10(8.81,40.00) ng/L vs 17.65(0.00,26.10) ng/L,29.53 (21.47,36.76) ng/L vs 22.79(1.19,28.29) ng/L](P＜0.05),but the expression of sPD-1 and sPD-L1 was not related with clinical characteristics of OLP.There were negative correlations between the levels of sPD-1 protein and CD4+T cells or CD 16++56+ cells(r1=-0.378,P1=0.007;r2=-0.365,P2=0.009),while there was a positive correlation between the levels of sPD-1 and CD19+B cells(r=0.482,P=0.000).There was a negative correlation between sPD-L1 expression level and CD4 + and a positive correlation between sPD-L1 expression level and IgG(r1=-0.286,P1=0.044;r2=0.365,P2=0.029).Conclusions In patients with OLP,the cellular immune function is low with humoral immunity function disorder.PD-1/PD-L1 signaling pathway,which might be influenced by the involvement of sPD-1 and sPD-L1 proteins in a certain extent,may play an important role in the immune pathogenesis of OLP.