Objective To evaluate the impact of healthcare-associated infection(HAI)control culture construction on the hand hygiene(HH)compliance of health care workers(HCWs),and provide a basis for strengthening HAI management.Methods HCWs in a hospital in Xi'an City were selected as the research objects.On the occasion of World HH Day,a series of publicity activities on HH as well as HAI prevention and control were held.Pre-activi-ties period was April 1-30,2024.During May 1-31,2024,a series of publicity activities on HH as well as HAI prevention and control were carried out.The post-activities investigation period was June 1-30,2024.During De-cember 1-31,2024,HH compliance survey was carried out in batches in the whole hospital(including key depart-ments).HH compliance at different stages was compared.Results After a series of publicity activities on HH as well as HAI prevention and control,HCWs'HH compliance rate was improved.HH compliance rate of nursing staff increased from 70.15％to 85.11％;HH compliance rate of HCWs before contacting with patients increased from 47.83％to 78.38％;both with statistically significant difference(both P＜0.05).During December 1-31,2024,a batch survey on HH compliance of the whole hospital(including key departments)showed that the HH compliance rates of medical and nursing staff in key departments were higher than those of the whole hospital,and the differences were statistically significant(all P＜0.05).HH compliance rates before aseptic operation and after contacting with patients in key departments were both higher than those of the whole hospital,and the differences were statistically significant(all P＜0.05).Conclusion Publicity activities on HH as well as HAI prevention con-trol can improve HH compliance rate of HCWs.HAI managers should pay more attention to the general depart-ments and improve HH compliance rate of HCWs.

Objective To translate the Urinary Incontinence Awareness and Attitude Scale(URINAS)and test its reliability and validity.Methods The Chinese version of the URINAS was developed by Brislin's translation model for translation,back translation,cultural adaptation,and pilot investigation.A convenience sampling method was used to select 384 urinary incontinence patients who visited a tertiary hospital in Nanchang,Jiangxi Province from June 2024 to October 2024 for investigation,in order to evaluate the reliability and validity of the scale.Results The Chinese version of the URINAS consisted of 5 dimensions with 26 entries.The Cronbach's alpha coefficient of this scale was 0.843;the folded half reliability was 0.917;the retest reliability was 0.852.The content validity of the scale at the level of the entries ranged from 0.846 to 1.000,and that at the level of the scale was 0.979.A total of 5 metrics were extracted by exploratory factor analysis,and the cumulative variance contribution rate of 74.286％.The results of the validation factor analysis showed a chi-square/degree of freedom of 2.268,a root mean square error of approximation of 0.064,a standardized fit index of 0.916,a Tucker-Lewis index of 0.923,a comparative fit index of 0.906,and a goodness-of-fit index of 0.922.Conclusion The URINAS has good reliability and validity,and can better reflect the level of patients' cognition and attitude towards urinary incontinence,thus providing theoretical basis for the development of corresponding intervention programs for such patients.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

BACKGROUND: P16 inactivation is frequently accompanied by telomerase reverse transcriptase ( TERT ) amplification in human cancer genomes. P16 inactivation by DNA methylation often occurs automatically during immortalization of normal cells by TERT . However, direct evidence remains to be obtained to support the causal effect of epigenetic changes, such as P16 methylation, on cancer development. This study aimed to provide experimental evidence that P16 methylation directly drives cancer development. METHODS: A zinc finger protein-based P16 -specific DNA methyltransferase (P16-Dnmt) vector containing a "Tet-On" switch was used to induce extensive methylation of P16 CpG islands in normal human fibroblast CCD-18Co cells. Battery assays were used to evaluate cell immortalization and transformation throughout their lifespan. Cell subcloning and DNA barcoding were used to track the diversity of cell evolution. RESULTS: Leaking P16-Dnmt expression (without doxycycline-induction) could specifically inactivate P16 expression by DNA methylation. P16 methylation only promoted proliferation and prolonged lifespan but did not induce immortalization of CCD-18Co cells. Notably, cell immortalization, loss of contact inhibition, and anchorage-independent growth were always prevalent in P16-Dnmt&TERT cells, indicating cell transformation. In contrast, almost all TERT cells died in the replicative crisis. Only a few TERT cells recovered from the crisis, in which spontaneous P16 inactivation by DNA methylation occurred. Furthermore, the subclone formation capacity of P16-Dnmt&TERT cells was two-fold that of TERT cells. DNA barcoding analysis showed that the diversity of the P16-Dnmt&TERT cell population was much greater than that of the TERT cell population. CONCLUSION P16 methylation drives TERT -mediated immortalization and transformation of normal human cells that may contribute to cancer development.
Humans ; Telomerase/genetics* ; DNA Methylation/physiology* ; Fibroblasts/cytology* ; Cyclin-Dependent Kinase Inhibitor p16/metabolism* ; Cell Line ; Cell Transformation, Neoplastic/genetics*

Objective To evaluate the impact of healthcare-associated infection(HAI)control culture construction on the hand hygiene(HH)compliance of health care workers(HCWs),and provide a basis for strengthening HAI management.Methods HCWs in a hospital in Xi'an City were selected as the research objects.On the occasion of World HH Day,a series of publicity activities on HH as well as HAI prevention and control were held.Pre-activi-ties period was April 1-30,2024.During May 1-31,2024,a series of publicity activities on HH as well as HAI prevention and control were carried out.The post-activities investigation period was June 1-30,2024.During De-cember 1-31,2024,HH compliance survey was carried out in batches in the whole hospital(including key depart-ments).HH compliance at different stages was compared.Results After a series of publicity activities on HH as well as HAI prevention and control,HCWs'HH compliance rate was improved.HH compliance rate of nursing staff increased from 70.15％to 85.11％;HH compliance rate of HCWs before contacting with patients increased from 47.83％to 78.38％;both with statistically significant difference(both P＜0.05).During December 1-31,2024,a batch survey on HH compliance of the whole hospital(including key departments)showed that the HH compliance rates of medical and nursing staff in key departments were higher than those of the whole hospital,and the differences were statistically significant(all P＜0.05).HH compliance rates before aseptic operation and after contacting with patients in key departments were both higher than those of the whole hospital,and the differences were statistically significant(all P＜0.05).Conclusion Publicity activities on HH as well as HAI prevention con-trol can improve HH compliance rate of HCWs.HAI managers should pay more attention to the general depart-ments and improve HH compliance rate of HCWs.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Objective To translate the Urinary Incontinence Awareness and Attitude Scale(URINAS)and test its reliability and validity.Methods The Chinese version of the URINAS was developed by Brislin's translation model for translation,back translation,cultural adaptation,and pilot investigation.A convenience sampling method was used to select 384 urinary incontinence patients who visited a tertiary hospital in Nanchang,Jiangxi Province from June 2024 to October 2024 for investigation,in order to evaluate the reliability and validity of the scale.Results The Chinese version of the URINAS consisted of 5 dimensions with 26 entries.The Cronbach's alpha coefficient of this scale was 0.843;the folded half reliability was 0.917;the retest reliability was 0.852.The content validity of the scale at the level of the entries ranged from 0.846 to 1.000,and that at the level of the scale was 0.979.A total of 5 metrics were extracted by exploratory factor analysis,and the cumulative variance contribution rate of 74.286％.The results of the validation factor analysis showed a chi-square/degree of freedom of 2.268,a root mean square error of approximation of 0.064,a standardized fit index of 0.916,a Tucker-Lewis index of 0.923,a comparative fit index of 0.906,and a goodness-of-fit index of 0.922.Conclusion The URINAS has good reliability and validity,and can better reflect the level of patients' cognition and attitude towards urinary incontinence,thus providing theoretical basis for the development of corresponding intervention programs for such patients.

Objective To investigate the dosimetric difference between manual and inverse optimization in 3-dimensional (3D) brachytherapy for gynecologic tumors. Methods This retrospective study was conducted among a total of 110 patients with gynecologic tumors undergoing intracavitary combined with interstitial brachytherapy or interstitial brachytherapy. Based on the original images, the brachytherapy plans were optimized for each patient using Gro, IPSA1, IPSA2 (with increased volumetric dose limits on the basis of IPSA1) and HIPO algorithms. The dose-volume histogram (DVH) parameters of the clinical target volume (CTV) including V200, V150, V100, D90, D98 and CI, and the dosimetric parameters D2cc, D1cc, and D0.1cc for the bladder, rectum, and sigmoid colon were compared among the 4 plans. Results Among the 4 plans, Gro optimization took the longest time, followed by HIPO, IPSA2 and IPSA1 optimization. The mean D90, D98, and V100 of HIPO plans were significantly higher than those of Gro and IPSA plans, and D90 and V100 of IPSA1, IPSA2 and HIPO plans were higher than those of Gro plans (P<0.05), but the CI of the 4 plans were similar (P>0.05). For the organs at risk (OARs), the HIPO plan had the lowest D2cc of the bladder and rectum;the bladder absorbed dose of Gro plans were significantly greater than those of IPSA1 and HIPO (P<0.05). The D2cc and D1cc of the rectum in IPSA1, IPSA2 and HIPO plans were better than Gro (P<0.05). The D2cc and D1cc of the sigmoid colon did not differ significantly among the 4 plans. Conclusion Among the 4 algorithms, the HIPO algorithm can better improve dose coverage of the target and lower the radiation dose of the OARs, and is thus recommended for the initial plan optimization. Clinically, the combination of manual optimization can achieve more individualized dose distribution of the plan.

Objective To investigate the dosimetric difference between manual and inverse optimization in 3-dimensional (3D) brachytherapy for gynecologic tumors. Methods This retrospective study was conducted among a total of 110 patients with gynecologic tumors undergoing intracavitary combined with interstitial brachytherapy or interstitial brachytherapy. Based on the original images, the brachytherapy plans were optimized for each patient using Gro, IPSA1, IPSA2 (with increased volumetric dose limits on the basis of IPSA1) and HIPO algorithms. The dose-volume histogram (DVH) parameters of the clinical target volume (CTV) including V200, V150, V100, D90, D98 and CI, and the dosimetric parameters D2cc, D1cc, and D0.1cc for the bladder, rectum, and sigmoid colon were compared among the 4 plans. Results Among the 4 plans, Gro optimization took the longest time, followed by HIPO, IPSA2 and IPSA1 optimization. The mean D90, D98, and V100 of HIPO plans were significantly higher than those of Gro and IPSA plans, and D90 and V100 of IPSA1, IPSA2 and HIPO plans were higher than those of Gro plans (P<0.05), but the CI of the 4 plans were similar (P>0.05). For the organs at risk (OARs), the HIPO plan had the lowest D2cc of the bladder and rectum;the bladder absorbed dose of Gro plans were significantly greater than those of IPSA1 and HIPO (P<0.05). The D2cc and D1cc of the rectum in IPSA1, IPSA2 and HIPO plans were better than Gro (P<0.05). The D2cc and D1cc of the sigmoid colon did not differ significantly among the 4 plans. Conclusion Among the 4 algorithms, the HIPO algorithm can better improve dose coverage of the target and lower the radiation dose of the OARs, and is thus recommended for the initial plan optimization. Clinically, the combination of manual optimization can achieve more individualized dose distribution of the plan.

Objective To study the diagnostic and therapeutic value of endoscopic irrigation for uncomplicated acute colonic diverticulitis.Methods From June 2021 to March 2022,4 patients suspected uncomplicated acute colonic diverticulitis who then underwent colonoscopy,and endoscopic irrigation treatment was performed after confirming.The endoscopic imaging of acute colonic diverticulitis was summarized.The changes of abdominal pain symptoms and prognosis of the patients were evaluated.The levels of white blood cell(WBC)and C-reactive protein(CRP)in serum before and after treatment were measured.Results 4 patients were diagnosed as uncomplicated acute colonic diverticulitis underwent colonoscopy.Two cases were located in the ascending colon and the other two in the cecum.Endoscopic imaging characteristics included mucosal hyperemia and swelling of diverticular orifice and nearby area,purulent secretions,purulent fur and fecalith at the diverticular orifice.After treatment,the symptom of abdominal pain was relieved,the levels of WBC and CRP in serum were lower than before treatment.Conclusion Endoscopic irrigation has a useful diagnostic and therapeutic value for uncomplicated acute diverticulitis of the colon.It is worthy of further clinical study.