Objective To construct a knowledge graph of healthcare-associated infection(HAI)prevention and control course,and evaluate its usability.Methods Based on the constructivist learning theory and the analyze-de-sign-develop-implement-evaluate(ADDIE)model,knowledge from various sources such as books,guidelines,and literature related to HAI prevention and control were integrated.The knowledge graph of HAI prevention and con-trol course were designed and constructed with the support of knowledge graph technology in Chaoxing Fanya plat-form.Thirty medical students were selected by convenience sampling method to try out the course knowledge graph.System usability scale and usage effect questionnaire were filled out to evaluate the usability of the knowledge graph.Results The knowledge graph of HAI prevention and control course contained 379 knowledge points asso-ciated with 520 test questions and 56 learning resources.After testing,the total score([70.50±12.20]points)was obtained for the usability of the knowledge graph.Among the four dimensions of the usage effect agreement ques-tionnaire,satisfaction,learning attitude,learning ability,and learning resource support accounted for 93.33％-96.67％,90.00％,93.33％-96.67％,and 83.33％-90.00％,respectively,with a high overall satisfaction rate.Conclusion The knowledge graph of HAI prevention and control course has good usability,which can realize students'personalized independent learning and improve their learning efficiency.

Objective To explore the protective effect and mechanism of Xinkang Granules-containing serum in adriamycin-induced injury of cardiomyocytes H9C2 based on cGAS-STING signaling axis.Methods Adriamycin was used to induce the H9C2 cells injury model.The cells were divided into normal group,model group,Xinkang Granules group and inhibitor group.After 24 hours of intervention,the CCK-8 method was used to detect cell survival rate,the DCFH-DA fluorescent probe was used to detect the content of cell reactive oxygen species(ROS),cell apoptosis rate was detected by flow cytometry,ELISA was used to detect the content of tumor necrosis factor-α(TNF-α)in cell supernatant,colorimetry was used to detect lactate dehydrogenase(LDH)in cells,RT-qPCR was used to detect the expression of mitochondrial transcription factor A(TFAM),cyclic guanosine-adenylate synthetase(cGAS),stimulator of interferon genes(STING)and TNF-α mRNA,Western blot and immunofluorescence were used to detect the protein expressions of cGAS and STING.Results Compared with the normal group,cell survival rate in the model group was significantly reduced(P<0.01),the ROS content was significantly increased(P<0.01),the apoptosis rate significantly increased(P<0.01),the content of TNF-α in the supernatant significantly increased(P<0.01),the activity of LDH significantly increased(P<0.01),the expression of TFAM mRNA significantly decreased(P<0.01),and the expressions of TNF-α,cGAS,STING mRNA and the protein expression of cGAS and STING significantly increased(P<0.01).Compared with the model group,cell survival rate in Xinkang Granules group and inhibitor group significantly increased(P<0.01),the ROS content significantly decreased(P<0.01),the apoptosis rate significantly decreased(P<0.01),the content of TNF-α in supernatant significantly decreased(P<0.01),the activity of LDH significantly decreased(P<0.01),the expression of TFAM mRNA significantly increased(P<0.01),and the expressions of TNF-α,cGAS,STING mRNA and the protein expressions of cGAS and STING significantly decreased(P<0.05,P<0.01).Conclusion Xinkang Granules have a protective effect on adriamycin-induced H9C2 cardiomyocytes,which may be related to the inhibition of cGAS/STING axis activation and the secretion of inflammatory factors.

This study aims to investigate the protective effect of naringenin(Nar)on cadmium(Cd)-induced liver injury in chickens and its regulatory role in endoplasmic reticulum stress(ERS)and autophagy.Forty-eight 1-day-old Hyland Brown egg roosters were divided into four groups:The control group,the Cd group(150 mg/kg CdCl2),the Nar group(250 mg/kg Nar),and the Cd+Nar group(150 mg/kg CdCl2+250 mg/kg Nar),and the rearing period was 60 days.On the 60th day,6 chickens were randomly selected from each group,and after fasting for 24 hours,blood was collected via vein and then removed from the neck and executed,the livers were collected and organ coefficients were calculated,changes in the content of liver function-related indexes were de-termined,pathological sections were made and observed,and the expression of mRNA and protein of related genes were detected by fluorescence quantitative PCR and Western blot method.The re-sults showed that Cd treatment resulted in a highly significant decrease(P＜0.01)in body mass,a highly significant increase(P＜0.01)in liver coefficient,a highly significant increase(P＜0.01)in serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),and lactate dehydrogenase(LDH)levels were highly significantly increased(P＜0.01),hepatic antioxidant capacity was highly significantly reduced(P＜0.01),and ERS-related genes(GRP-78,PERK,eIF-2α,CHOP,ATF-4,ATF-6)and autophagy-related genes(Atg-5,Beclin-1,LC3)mRNA expression was highly significantly up-regulated(P＜0.01),and the expression of mRNA for p62 was highly significantly reduced(P＜0.01).After the addition of Nar,Cd-induced liver injury was significantly alleviated,liver function indexes improved,hepatic antioxidant capacity was highly significantly el-evated(P＜0.01),mRNA expression of ERS-related genes(GRP-78,PERK,eIF-2α,CHOP,ATF-4,ATF-6)and autophagy-related genes(Atg-5,Beclin-1,LC3)was highly significantly decreased(P＜0.01)and mRNA expression of P62 was highly significantly increased(P＜0.01).This study suggests that Nar has potential in alleviating Cd-induced liver damage in chickens through the reg-ulation of ERS and autophagy,providing theoretical support for its application in livestock health.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

This study aims to investigate the protective effect of naringenin(Nar)on cadmium(Cd)-induced liver injury in chickens and its regulatory role in endoplasmic reticulum stress(ERS)and autophagy.Forty-eight 1-day-old Hyland Brown egg roosters were divided into four groups:The control group,the Cd group(150 mg/kg CdCl2),the Nar group(250 mg/kg Nar),and the Cd+Nar group(150 mg/kg CdCl2+250 mg/kg Nar),and the rearing period was 60 days.On the 60th day,6 chickens were randomly selected from each group,and after fasting for 24 hours,blood was collected via vein and then removed from the neck and executed,the livers were collected and organ coefficients were calculated,changes in the content of liver function-related indexes were de-termined,pathological sections were made and observed,and the expression of mRNA and protein of related genes were detected by fluorescence quantitative PCR and Western blot method.The re-sults showed that Cd treatment resulted in a highly significant decrease(P＜0.01)in body mass,a highly significant increase(P＜0.01)in liver coefficient,a highly significant increase(P＜0.01)in serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),and lactate dehydrogenase(LDH)levels were highly significantly increased(P＜0.01),hepatic antioxidant capacity was highly significantly reduced(P＜0.01),and ERS-related genes(GRP-78,PERK,eIF-2α,CHOP,ATF-4,ATF-6)and autophagy-related genes(Atg-5,Beclin-1,LC3)mRNA expression was highly significantly up-regulated(P＜0.01),and the expression of mRNA for p62 was highly significantly reduced(P＜0.01).After the addition of Nar,Cd-induced liver injury was significantly alleviated,liver function indexes improved,hepatic antioxidant capacity was highly significantly el-evated(P＜0.01),mRNA expression of ERS-related genes(GRP-78,PERK,eIF-2α,CHOP,ATF-4,ATF-6)and autophagy-related genes(Atg-5,Beclin-1,LC3)was highly significantly decreased(P＜0.01)and mRNA expression of P62 was highly significantly increased(P＜0.01).This study suggests that Nar has potential in alleviating Cd-induced liver damage in chickens through the reg-ulation of ERS and autophagy,providing theoretical support for its application in livestock health.

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by synovial inflammation, joint destruction, and functional impairment. Angiogenesis plays a key role in the pathological progression of RA with dysfunction of endothelial cells to promote synovial inflammation, sustain pannus formation, subsequently leading to joint damage. Colquhounia Root Tablets (CRT), a Chinese patent drug, has shown a satisfying clinical efficacy in treating RA, while the underlying mechanism by which CRT inhibits RA-associated angiogenesis remains unclear. In this study, we applied a research approach combining transcriptomic data analysis, bio-network mapping, and in vivo and in vitro experiments to explore the molecular mechanisms of CRT in suppressing angiogenesis in RA. Animal welfare and experimental procedures follow the regulations of the Animal Ethics Committee of Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences (ratification number: IBTCMCACMS21-2307-06). Network analysis identified that key genes such as nucleotide-binding oligomerization domain-containing protein 2 (NOD2), SMAD family member 3 (SMAD3), and vascular endothelial growth factor A (VEGFA) significantly enriched in pathways related to NOD-like receptor signaling and VEGF signaling, indicating that CRT may inhibit angiogenesis by regulating vascular endothelial cell function with modulating angiogenesis-related pathways. In vivo data showed that CRT significantly reduced the positive expression of CD31 and VEGF in the ankle joint of adjuvant-induced arthritis (AIA) rats. In vitro data further confirmed that CRT effectively inhibited VEGF-induced migration, invasion, and tube formation in HUVECs, while significantly reduced the expression of angiogenesis-related factors VEGF/CD31/Ang-1, as well as the positive expression of VEGF and CD31 in HUVECs. Furthermore, CRT markedly decreased the protein expression of NOD2, VEGFA, and SMAD3. In conclusion, these findings indicate that CRT may inhibit the RA-related angiogenesis by targeting the NOD2/SMAD3/VEGF signaling axis to improve endothelial cell function, enriching the scientific connotation of CRT in inhibiting pathological angiogenesis in RA and also offer new insights for clinical prevention and treatment of RA.

Quality control is a key link in the modernization process of traditional Chinese medicine(TCM). Studies have shown that the effects of active components in TCM depend on not only their chemical composition but also their suitable physical forms and states. The physical phase structures, such as micelles, vesicles, gels, and nanoparticles, can improve the solubility, delivery efficiency, and targeting precision of active components. These structures significantly enhance the pharmacological activity while reducing the toxicity and side effects, demonstrating functional activity surpassing that of active components and highlighting the key effects of "structures" on "functions" of active components. Taking the physical phase structure as a breakthrough point, this paper outlines the common types of TCM physical phase structures. Furthermore, this paper explores how to realize the quality upgrading of TCM through the precise regulation of physical phase structures based on the current applications and potential of TCM physical phase structures in processing to increase the efficacy and reduce the toxicity, compounding and decocting processes, drug delivery systems, and quality control, aiming to provide novel insights for the future quality control of TCM.
Quality Control ; Drugs, Chinese Herbal/standards* ; Medicine, Chinese Traditional/standards* ; Humans ; Drug Delivery Systems

OBJECTIVE: To assess the value of the Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1) score combined with PSA density (PSAD) in the diagnosis of clinically significant prostate cancer (CSPCa) in the PSA grey zone by MRI-TRUS cognitive fusion-guided transperineal targeted prostate biopsy. METHODS: This retrospective study included 327 male patients with total PSA (tPSA) levels of 4-10 μg/L undergoing MRI-TRUS cognitive fusion-guided transperineal targeted prostate biopsy in our hospital between January 2021 and December 2023. According to the pathological results, we divided the patients into a CSPCa (n = 44) and a non-CSPCa group (n = 283), collected their clinical and imaging data, and subjected them to statistical analysis. RESULTS: The age, tPSA level, PSAD and PI-RADS score were significantly higher, while the free PSA (fPSA) level, f/tPSA ratio and prostate volume remarkably lower in the CSPCa than in the non-CSPCa group (P<0.05). The areas under the curve (AUCs) of PSAD, PI-RADS score and their combination were 0.772, 0.730 and 0.801, with sensitivities of 63.63%, 70.45% and 72.73%, and specificities of 84.10%, 75.62% and 83.75%, respectively (P<0.01). With PSAD 0.2 μg/(ml·cm3) as the best cut-off value and based on the PI-RADS scores, the patients were divided into two groups for analysis. In the patients with PI-RADS scores 2 and 5, the AUCs were 0.534 and 0.643, with sensitivities of 16.67% and 63.64%, and specificities of 85.14% and 64.29%, with no statistically significant differences (P= 0.784, P= 0.228), and in those with PI-RADS scores 3 and 4, the AUCs were 0.794 and 0.843, with sensitivities of 57.14% and 80.00%, and specificities of 87.14% and 81.82%, with statistically significant differences (P= 0.009, P<0.001). CONCLUSION PI-RADS v2.1 score combined with PSAD can effectively improve the diagnostic efficiency of CSPCa in the PSA grey zone by MRI-TRUS cognitive fusion-guided transperineal targeted prostate biopsy and serve as a guide for selection of prostate biopsy.
Humans ; Male ; Prostatic Neoplasms/diagnostic imaging* ; Retrospective Studies ; Prostate-Specific Antigen ; Magnetic Resonance Imaging ; Image-Guided Biopsy ; Prostate/pathology* ; Aged ; Middle Aged

OBJECTIVE: To evaluate the efficacy and safety of Chinese medicine (CM) Zihua Wenfei Zhisou Granule (ZWZG) in postinfectious cough (PIC) patients with CM syndrome of wind-cold invading Fei (Lung, WCIF). METHODS: This is a multicenter, randomized, double-blind, parallel-group, placebo-controlled phase II clinical trial. PIC patients with WCIF syndrome were recruited from the Respiratory Departments in 6 hospitals across China between March 2019 and December 2020. Eligible patients were randomly assigned to group A (ZWZG-matched placebo 15 g), group B (active ZWZG 15 g), and group C (active ZWZG 10 g plus ZWZG-matched placebo 5 g) in a 1:1:1 ratio. All medications were taken orally 3 times daily for 14 consecutive days. The primary outcomes were cough relief rate and cough disappearance rate. The secondary outcomes included time to cough relief, time to cough disappearance, and changes in cough symptom score (CSS), cough Visual Analog Scale (VAS) value, Cough-Specific Quality of Life Questionnaire (CQLQ) score, and CM syndrome score from baseline (day 0) to post-treatment (day 14). Adverse events (AEs) in each group were recorded. RESULTS: A total of 198 patients were included in the full analysis set (FAS) and safety analysis set (SS), while 183 were enrolled in the per-protocol analysis set (PPS). In the FAS population, the cough relief rate was 47.76%, 90.77% and 84.85% in groups A, B, and C, respectively; while the cough disappearance rate was 31.34%, 72.31% and 68.18%, respectively. The cough relief rates and cough disappearance rates in groups B and C were significantly higher than group A (P<0.0001). Both the median time to cough relief and cough disappearance in groups B and C were shorter than group A (P<0.0001). Compared with group A, groups B and C showed significantly greater improvements from baseline to post-treatment in CSS during daytime and nighttime as well as VAS (P<0.05). There were no significant differences in changes from baseline to post-treatment in CQLQ and CM syndrome scores among 3 groups (P>0.05). Results in the PPS population were consistent with those in the FAS population. Groups B and C showed lower incidence in AEs than group A (P<0.05), while there was no significant difference between groups B and C (P>0.05). No drug-related severe AEs were reported. CONCLUSIONS ZWZG can increase cough disappearance rate and cough relief rate; and it is beneficial in shortening cough duration and reducing cough severity and frequency in patients suffering from PIC. It is safe and generally well tolerated. (Registration No. ChiCTR1900022078).
Humans ; Cough/drug therapy* ; Double-Blind Method ; Male ; Female ; Drugs, Chinese Herbal/adverse effects* ; Middle Aged ; Treatment Outcome ; Adult ; Aged ; Quality of Life