Objective: To investigate the current status of knowledge and practice pertaining to nosocomial infection control among medical professionals in grassroots healthcare institutions, so as to provide the evidence of improving the level of infection control in grassroots healthcare institutions. Methods: All medical professionals working in grassroots healthcare institutions in Pukou District, Nanjing City, were enrolled. The participants' demographic features and knowledge and practice of nosocomial infection control were collected using self-designed questionnaires and descriptively analyzed. Results: A total of 402 participants were enrolled, included 116 men ( 28.86% ) and 286 women ( 71.14% ). The respondents were predominantly at ages of 41 years and older ( 187 subjects, 46.52% ), with bachelor and above as the predominant educational level ( 200 subjects, 49.75% ) and intermediate title and above as the predominant professional title ( 168 subjects, 41.79%) , and there were 236 participants ( 58.71% ) with the length of service for more than 10 years. The awareness rate of nosocomial infection control knowledge was 56.22% among medical professionals working in grassroots healthcare institutions, with the highest awareness for COVID-19 prevention and control ( 89.55% ) and the lowest awareness for the key aspects in nosocomial infection control ( 39.55% ). The formation rate of implementing nosocomial infection control practices was 84.08%, with a low rate for “Implement satisfactorily the isolation interventions for patients with multidrug resistant bacteria” ( 71.14% ) and “Implement satisfactorily the control measures for nosocomial infections in key departments and key aspects”( 64.68% ). Conclusions Low levels are seen in the awareness of nosocomial infection control, behaviors of multidrug resistance management and key aspects in nosocomial infection control among medical professionals in grassroots healthcare institutions in Pukou District.

Objective To investigate the expressions of tetraspanin CO-029 in intrahepatic cholangiocarcinoma (ICC) and to find out their clinical significance.Methods RT-PCR and western blot were used to detect the expressions of CO-029 in ICC and their matched para-tumorous tissues from 20 patients with ICC,as well as in the HCCC-9810 cell lines.The expressions of CO-029 were further detected via tissue microarray (TMA) in the pathological specimens of 40 patients with ICC.Correlations between the expressions of CO-029 and the clinicopathologic features and prognosis were analyzed.Results A high level of CO-029 was detected in the 20 patients with ICC and the HCCC-9810 cell lines via western blot and RTPCR.Moreover,the expression levels of CO-029 in the ICC tissues were higher than the matched para-tumorous tissues (P ＜ 0.05).TMA detection revealed the positive expression rate of CO-029 to be 65％ (26/40).The expression level of CO-029 was much higher in the early recurrence group (Time to recurrence,TTR ＜ 1 year) than the non-recurrence group (TTR≥ 1 year).On analysis,the correlations were significant between the expressions of CO-029 and tumor encapsulation,hilar lymph node metastasis,TNM stage and prognosis (P ＜0.05).Conclusions CO-029 was highly expressed in ICC.It had close correlations with recurrence,metastasis and prognosis of patients with ICC.

Objective To investigate the effects of small interfering RNA(siRNA)on the expression of CD147 on peripheral blood T-lymphocytes from patients with psoriasis vulgaris,and its effect on the proliferation and activation of these cells.Methods Peripheral blood monouclear cells(PBMC)were obtained from 10 patients with psoriasis vulgaris,and T lymphocytes were isolated.CD147 siRNA was chemically synthesized,then electroporated into the peripheral T-lymphocytes.Untransfected cells,blank-transfected cells and unspecifically transfected cells served as the control.After 24-,48-,72-and 96-hour incubation,RT-PCR was used to detect the mRNA expression of CD147 in these cells.MTT assay and flow cytometry were utilized to assess the proliferation of these cellas,and the expression Of CD25 at 24,48,and 72 hours after the transfection.Results Compared with untransfected cells,the mRNA expression of CD147 declined significantly in CD147 siRNA-transfected cells at 24 hours(P＜0.05),reached to the minimum at 48 hours (P＜0.01):there was no significant difierence in the expression of CD147 between the two groups of cells at 96 hours after the transfection(P＞0.05).There was a decrease of cell proliferation level by(44.5±3.13)%,(50.7±3.5)%and(53.98±4.15)%in CD147 siRNA-transfected cells 24,48 and 72 hours following the transfection,respectively;the corresponding decrease in blank-transfected cells was (37.28±3.56)%,(33.73±3.29)%,and(28.80±1.49)%,respectively,and that in unspecifically transfected cells,(31.29±2.46)%,(36.1±2.62)%and(32.08±2.78)%,respectively.A significant decrease was observed in the proliferation of CD147 siRNA-transfected cells compared with that of blank-transfected cells and unspecifically transfected cells at these three time points(P＜0.05,0.01,0.01 respectively).The expression rate of CD25 at 24,48 and 72 hours was(47.23±3.65)%,(31.50±4.22)%and(23.05±4.15)%,respectively,on CD147 siRNA-transfected cells,and,(80.2±4.8)%,(81.6±3.35)%and(83.5±4.1)%,respectively,on untransfeeted cells;the differences between the two groups at the three time points were statistically significant(all P＜0.01).Conclusion CD147 is correlated with cell proliferation and activation of peripheral T lymphoeytes from patients with psoriasis vulgaris,and may serve as a new treatment target for psoriasis.

Objective To investigate the role of transmembrane protein C0-029 in epithelial mesenchymal transition (EMT) induced by tumor necrosis factor alpha (TNFα) of intrahepatic cholangiocarcinoma (ICC) cells.Methods RT-PCR and Western blot were conducted to detect the CO-029 expression in ICC cells and tissues.The effect of CO-029 silencing by lenti-virus on EMT induced by TNFα was investigated.Western blot and mass spectrometry after immunoprecipitation were used to confirm whether TNFαR1 can directly or indirectly bind with CO-029 to form complexes in ICC.Results Differential expression of CO-029 was observed in ICC cells and tissues.The expression of CO-029 was significantly reduced by lenti-viral interference in ICC cells,resulting in the failure of TNFα to induce EMT.TNFαR1 in ICC could directly or indirectly form complexes with CO-029.Conclusion CO-029 mediates TNFα/TNFαR1 induced EMT in ICC,which might play an important role in the invasion and metastasis.

AIM:To study the effect of astragalus polysaccharides(Aps)on cholesterol efflux in THP-1 macrophage-derived foam cells.METHODS:After exposed to Aps at different doses,cholesterol efflux and ABCA1 protein levels in cultured THP-1 macrophage-derived foam cells were determined by a ? counter and flow cytometry,respectively.RESULTS:Aps increased cholesterol efflux in THP-1 macrophage-derived foam cells with dose dependent pattern and resulted in an increase in the expression of ABCA1 protein in THP-1 macrophage-derived foam cells.CONCLUSION:The increase in cholesterol efflux by Aps might be related to the up-regulation of ABCA1.

Objective:To explore the core targets and potential molecular mechanisms of tetramethylpyrazine in the treatment of rats with acute necrotizing pancreatitis (ANP) based on network pharmacology.Methods:The related co-targets of tetramethylpyrazine and ANP were screened out by traditional Chinese medicine systems pharmacology database and analysis platform (TCMSP) and human disease information-related databases (CTD, DisGeNET, GeneCards, OMIM); Uniprot data were used to co-link and put into the STRING database to build protein-protein interaction (PPI) networks; the Cytoscape software was used for further analysis and the key targets were obtained by using the cytoHubba plug-in. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed on these key targets, and finally the molecular docking models were constructed by using PyMol and AutoDockTools software. 30 male SD rats were randomly divided into the control group, ANP group, and tetramethylpyrazine treatment group (tetramethylpyrazine group). ANP rats were induced by retrograde infusion of 4% sodium taurocholate into the biliary-pancreatic duct, and the tetramethylpyrazine group rats were injected with 10 ml/kg tetramethylpyrazine through the abdominal cavity after ANP was induced. After 12 h, pancreatic tissue was taken, a pathological examination was performed routinely, and immunohistochemical staining was performed to observe the protein expression of key targets in pancreatic tissue. Blood was taken from orbits, and then the serum IL-6 and tumor necrosis factor-α (TNF-α) levels were measured by enzyme-linked immunosorbent assay (ELISA).Results:The drug platform screened 137 tetramethylpyrazine action targets, and the disease database screened out 513 ANP-related targets; then 25 targets were obtained through intersection, finally resulting in a total of 5 key targets: albumin (ALB), epidermal growth factor receptor (EGFR), caspase 3 (CASP3), mitogen-activated protein kinase 1 (MAPK1) and B-cell lymphoma-2-like protein 1 (BCL2L1). GO functional enrichment analysis of biological processes mainly involved reproductive structure or system development, response to antibiotics, chemical stress and reactive oxygen species, and the cellular components were mainly vesicle lumen, membrane raft, membrane microdomain, and secretory granule lumen; molecular functions mainly included SH2 domain, phosphotyrosine residue, protease binding, protein tyrosine kinase and nuclear receptor activity; KEGG pathway enrichment analysis were mainly enriched in Ras signaling pathway, PI3K-Akt signaling pathway, platinum drug resistance, phospholipase D signaling pathway, and EGFR tyrosine kinase inhibitor resistance. The average binding energy of the 5 key targets molecule docking was -4.20 kcal/mol. After hematoxylin-eosin staining, it could be seen that the gland structure of rats in the ANP group was disordered, the interlobular space was significantly increased, and neutrophil infiltration was observed in the acinar, perivascular and gland space. The pancreatic lobule space of tetramethylpyrazine group rats was slightly increased, with mild neutrophil infiltration. The protein expressions of EGFR, CASP3 and MAPK1 in the ANP group were significantly higher compared with those in the control group, and EGFR, CASP3 and MAPK1 expression in tetramethylpyrazine group was significantly lower than those in ANP group ( P<0.01); the protein expression of BCL2L1 in the ANP group were significantly higher than that in control group, and the protein expression of BCL2L1 in tetramethylpyrazine group were significantly higher than that in ANP group (all P value <0.05). The serum levels of IL-6 and TNF-α in the ANP group were significantly higher than those in the control group, and IL-6 and TNF-α in tetramethylpyrazine group were significantly lower than those in the ANP group (all P value <0.01). Conclusions:Tetramethylpyrazine could reduce the inflammatory response and oxidative stress injury after ANP by activating a variety of signaling pathways, enhancing the expression of anti-apoptotic genes, and blocking the enzymatic cascade reaction of apoptotic caspase, thus playing a protective role in pancreatic tissues of rats with ANP.

Objective:To evaluate the health related quality of life (HRQoL) of hip fracture patients after surgery and build a prediction model to identify high-risk patients with HRQoL decline.Methods:A cross-sectional research method was applied to select 135 patients with unilateral hip fractures from January 2020 to June 2021 in Hainan Provincial Hospital of Traditional Chinese Medicine using convenience sampling as the study population. HRQoL was self-assessed using the European Five-Dimensional Health Scale (EQ-5D).Logistic regression models were used to identify risk factors for HRQoL decline. The columnar plots′ predictive accuracy and net clinical benefit were assessed using calibration curves, ROC curves, and decision curve analysis (DCA).Results:The final number of patients with valid follow-up was 122.At 6 and 12 months postoperatively, the EQ-5D index was lower than before the fracture in 41(33.6%) patients, showing a strong correlation with the Barthel index ( r=0.833, 0.705, both P<0.05). Nutritional Risk Screening 2002 (NRS-2002) ( OR=1.352), Charlson Comorbidity Index (CCI) ( OR=1.121), hip replacement ( OR=0.795), and lung infection ( OR=1.328) were independently associated with a decrease in HRQoL in patients with hip fracture (all P<0.05). The consistency index (C-index) of the column line plot was 0.889 (0.791 to 0.955), and the area under the curve (AUC) was 0.871 (0.784 to 0.947). The DCA results showed that the model provided good net clinical benefit. Conclusions:The model can effectively identify patients at high risk of declining HRQoL, which is helpful to determine priority patients to provide nursing strategies.

Objective To validate the antiviral effect of oxymatrine against hepatitis C virus (HCV) in the construction of the cell culture-based infectious virus system HCVcc.Methods An HCVcc system was established by infecting Huh7.5.1 cells with the J6 adapted virus (J6cc).Cells of the HCVcc system were then treated with different concentrations of oxymatrine for 24 h,48 h and 72 h,or left untreated (controls).MTT assay was used to detect effects on proliferation.Real-time quantitative PCR was used to detect effects on HCV mRNA expression level,and immunofluorescence was used to detect effects on HCV protein expression.Data were expressed as mean±standard deviation,and statistically assessed using one-way ANOVA and one-sample t-test.Results Treatment with 2,4,8 and 12 mg/mL of oxymatrine for 24 h inhibited proliferation of the J6cc-infected cells by 8.4％,15.2％,29.6％ and 48.6％ respectively,48 h treatment inhibited by 14.3％,25.7％,46.1％ and 66.4％ respectively,and 72 h treatment inhibited by 36.5％,46.6％,70.6％ and 85.4％ respectively.Thus,the effects of oxymatrine were time-and dose-dependent (P ＜ 0.05).The mRNA expression level in the oxymatrine-treated cells of the HCVcc system was 0.59 ± 0.12,which was significantly lower than that in the control cells (P ＜0.05).Moreover,as the oxymatrine concentration increased from 2 mg/mL to 12 mg/mL,the expression levels of HCV proteins also showed a decreasing trend.Conclusion We successfully constructed a J6cc infection HCVcc system and verified the antiviral effect of oxymatrine against HCV.

Objective:To study the predictive value of systemic immune-inflammation index (SII), alpha-fetoprotein (AFP) and tumor diameter on microvascular invasion (MVI) in patients with resectable hepatocellular carcinoma (HCC), with an aim to establish a preoperative prediction model.Methods:The clinical data of 283 patients who underwent hepatectomy at the First Affiliated Hospital of Nanchang University from September 2017 to September 2020 were retrospectively analyzed. In the 283 patients with HCC who were included into this study, 249 were males and 34 were females, aged (53.7±11.0) years. Using postoperative pathology findings, these patients were divided into two groups: the MVI negative group ( n=140) and the MVI positive group ( n=143). Correlation between MVI and related indicators was analyzed using logistic regression analysis. The prediction model of MVI was then established by selecting independent risk factors. Univariate and multivariate analysis of recurrence-free survival (RFS) were performed using the Cox proportional hazards regression model. Results:Multivariate logistic regression analysis showed that AFP>400 ng/ml ( OR=2.304, 95% CI: 1.329-3.995, P=0.003), SII>376.30×10 9/L ( OR=2.249, 95% CI: 1.299-3.894, P=0.004) and tumor diameter>5 cm ( OR=2.728, 95% CI: 1.587-4.687, P<0.001) were independent risk factors for MVI. The Cox proportional hazards regression model showed that AFP ( HR=1.663, 95% CI: 1.063-2.602, P=0.026) and SII ( HR=1.851, 95% CI: 1.173-2.920, P=0.008) were independent risk factors for RFS in HCC patients. The sensitivity and specificity of the model based on SII, AFP and tumor diameter were 59.4% and 75.7%, respectively. Conclusions:SII, AFP and tumor diameter were closely related to occurrence of MVI in patients with HCC. AFP and SII were independent prognostic factors of RFS. This prediction model has certain predictive values for occurrence of MVI and prognosis of HCC patients.

Objective Metabolites produced by metabolic imbalance such as free fatty acids and lipopolysaccharides can result in a state of chronic low-grade inflammation, or metabolic inflammation, which plays an important role in the pathogenesis of atherosclerosis, type 2 diabetes, non-alcoholic fatty liver disease, and obesity. The above metabolic disorders are closely related with the metabolic inflammation, which always coexist. Therefore, we proposed the concept ofmetabolic inflammatory syndrome ( MIS). According to our study, patients with two or more metabolic disorders above could be diagnosed as MIS. The current research is aimed to investigate the prevalence of MIS and its components, and to compare the clinical values of MIS and metabolic syndrome ( MS) . Methods 2 001 in patients with type 2 diabetes from 6 hospitals in Shanghai were recruited in the current multi-center cross-sectional study. The diagnostic rates of MIS and MS and their components of both syndromes were compared. Results In the patients with type 2 diabetes, the detective rate of MIS was 96. 2%, which was higher than that of MS (71. 3%). Among 4 components of MIS, atherosclerosis showed the highest detective rate (75.6%). MIS[OR=2.252(95%CI1.026-4.942),P=0.043],atherosclerosis[OR=2.726(95% CI1.953-3. 804),P<0. 001], and MS[OR=1. 915 (95%CI 1. 444-2. 540),P<0. 01] were the risk factors of coronary heart disease. Conclusion With atherosclerosis, type 2 diabetes mellitus, non-alcoholic fatty liver disease, and obesity as its 4 components, MIS has a high detective rate in patients with metabolic disorders, and seems to be more sensitive than MS to distinguish inflammation-related metabolic diseases. The concept of MIS will promote the screening and prevention of atherosclerosis in its early stage.