Objective To assess the current status of microbial and parasitic quality control for laboratory animals in Jiangxi Province by analyzing microbiological and parasitic test results from production facilities between 2020 and 2024, and to provide a basis for enhancing quality control measures. MethodsIn accordance with the current national standards for laboratory animals at the time of testing, the Jiangxi Provincial Laboratory Animal Quality Inspection Station (affiliated to Institute of Occupational Medicine of Jiangxi) conducted microbial and parasitic testing on 451 laboratory animals of 4 species from 6 laboratory animal production units in Jiangxi Province between 2020 and 2024, and analyzed the quality status of laboratory animals in the province. ResultsPasteurella pneumotropica was detected in one mouse sample in 2020, with a detection rate of 5.00%. Pseudomonas aeruginosa was detected in one mouse sample and mouse hepatitis virus antibody was detected in another mouse sample in 2023, with a detection rate of 2.78%, respectively. No microorganisms or parasites that should be excluded from SPF grade mice as specified in the national standards were detected in 2021, 2022, or 2024, with a qualification rate of 100.00%. Pasteurella pneumotropica was detected in four rat samples in 2020, with a detection rate of 20.00%. Pseudomonas aeruginosa was detected in two rat samples in 2021, with a detection rate of 10.00%, and Tyzzer's disease agent antibody was detected in four rat samples in 2024, with a detection rate of 10.00%. No microorganisms or parasites that should be excluded from SPF grade rats as specified in the national standards were detected in 2022 or 2023, with a qualification rate of 100.00%. For rabbits and guinea pigs, no microorganisms or parasites required to be tested for conventional grade rabbits and guinea pigs as specified in the national standards were detected from 2020 to 2024, with the qualification rate of both species reaching 100.00%. ConclusionBased on the microbial and parasitic testing results, the quality of rabbits and guinea pigs in Jiangxi Province is satisfactory. However, some issues persist with rats and mice. It is recommended to enhance the quality of experimental animals in Jiangxi Province by increasing the frequency of random inspections by quality testing units or by improving the self-inspection capabilities of production and user facilities.

Objective:To explore the correlation of bone metabolism with vitamin D and vitamin K levels in children with glucocorticoid-induced osteoporosis (GIOP) .Methods:A total of 120 GIOP children admitted to Neonatal Department of the First People’s Hospital of Chenzhou City, Hunan Province from Oct. 2022 to Dec. 2024 (GIOP group) and children without osteoporosis who received glucocorticoid therapy during the same period (the control group) were studied. Bone mineral density (BMD), biochemical indexes of bone metabolism and serum 25-hydroxyvitamin D (25 (OH) D), vitamin K1 (VitK1) and VitK2 were determined. BMD and bone metabolism indexes of GIOP children with different levels of 25 (OH) D, VitK1 and VitK2 were compared and their correlation was analyzed. Multiple linear regression analysis was conducted to analyze the independent factors affecting low BMD in GIOP children.Results:GIOP group had lower BMD, serum 25 (OH) D, VitK1 and VitK2 levels ( t=33.03, 42.22, 65.30, 86.16, P<0.05), while higher PINP, β-CTX and N-MID levels ( t=17.98, 34.78, 2.58, P<0.05); The levels of VitK1, VitK2, BMD, PINP, β-CTX and N-MID in GIOP children with different vitamin D and K levels were statistically significant ( F =54.31, 36.77, 82.32, 32.40, 22.80, 5.23), among which BMD was the lowest and PINP, β-CTX and N-MID levels were the highest ( P<0.05); The levels of 25 (OH) D, VitK1 and VitK2 were positively correlated with BMD ( r=0.54, 0.39, 0.47, P<0.05), but negatively correlated with PINP, β-CTX and N-MID ( r = -0.43, -0.34, -0.38, -0.39, -0.45, -0.44, -0.29, -0.32, -0.51, P<0.05); 25 (OH) D, VitK1 and VitK2 were protective factors for low BMD ( t=-2.76, -2.55, -3.51, P<0.05), while PINP, β-CTX, N-MID and hormone use time were risk factors ( t=2.48, 2.19, 2.22, 2.06, P<0.05) . Conclusions:The level of bone metabolism in children with GIOP is closely related to the levels of vitamin D and vitamin K. With the decrease of vitamin D and vitamin K levels, the decrease of BMD is more obvious. Therefore, vitamin D and vitamin K should be supplemented in a timely and reasonable manner for such children.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Objective To understand the implementation of WS/T 508-2016 and the status of washing and disin-fection of medical textiles in China,and provide basis for the revision of the standard.Methods A questionnaire survey was conducted on the management of medical institutions and washing and disinfection workplace,building layout,personnel protection,equipment and supplies,washing and disinfection principles,and hygiene quality mo-nitoring of medical textiles in 323 medical institutions and 31 washing institutions in China.Meanwhile,microbio-logical index sampling was conducted on 234 pieces of medical textiles in 9 medical institutions and 8 washing insti-tutions in Hubei,Shanxi,Shanghai,and Sichuan Provinces before and after washing and disinfection.Results The awareness rates of WS/T 508-2016 among medical institutions and washing institutions were 96.90％and 96.77％,respectively,and the implementation rates were 94.12％and 96.77％,respectively.47.99％medical in-stitutions use purchasing services for washing and disinfecting medical textiles,and the higher the level of the medi-cal institution was,the higher the proportion of purchasing services was(x2=15.312,P＜0.001).85.16％medi-cal institutions have conducted risk assessments on service providers,and 52.99％were responsible for or participa-ted in pre-job training by the medical institution.Washing institutions were higher than medical institutions in terms of system soundness rate,pre-job training rate,proportion of quality management leaders and full-time(part-time)quality inspectors,setting rate of hand-washing facilities in zones,passages,isolation barriers,dressing(buffer)room,and toilets,configuration rate of hygiene isolation washing equipment,tunnel washing unit,washing equip-ment with heating functions,drying equipment and mechanical ventilation facilities,and specialty machine washing rate.Among 234 medical textiles specimens,11.97％were detected fungi,and the total fungal colonies in 5 clean textiles exceeded 100 CFU/100 cm2.Conclusion WS/T 508-2016 can further standardize the washing and disin-fection of medical textiles in China through strengthening institutional management,improving the supervision level of service providers,perfecting hardware facilities and layout,introducing new technologies,and increasing the mo-nitoring on fungi in clean textiles.

Objective To explore the dual coping experience of nursing dependence among middle-aged and young patients with enterostomy and their primary caregivers from the perspective of family resilience,in order to provide evidence for improving the experience of nursing dependence and promoting family resilience.Methods Us-ing the phenomenological research method in qualitative research,18 young and middle-aged enterostomy patients and their primary caregivers were selected for semi-structured interviews with purpose sampling method,and the in-terview data were analyzed by content analysis method.Results A total of 4 themes and 8 sub-themes were ex-tracted.Theme 1:heavy dependence-elastic fatigue-weak resilience(patients avoid stomas,depression,caregivers help-lessly accepting;patients role reinforcement,excessive dependence,caregivers exhaustion);theme 2:moderate depen-dence-elastic adjustment-strong resilience trend(active exploration,mutual understanding,perceived support;focus ad-justment,mutual dependence,positive relationship);theme 3:mild dependence-elastic space-strong resilience(self-con-trollable feeling,quick adaptation,mutual growth;facing calmly,cherishing life,reshaping value);theme 4:no depen-dence-gradual loss of elasticity-weak resilience trend(refusal to seek help,self isolation,relationship cracks;frustration in seeking help,self-protection,relationship alienation).In this article,we proposed a preliminary family resilience model for patients with enterostomy.Conclusion The dual coping and family resilience of the patients with en-terostomy and their primary caregivers are different and dynamic.Family-centered support should be applied to strengthen the positive coping and improve the level of family resilience.In addition,this study also tried to pro-pose a family resilience model for patients with enterostomy based on nursing dependence,in order to enrich the connotation of family resilience.

Objective To explore the experiences of children with Crohn's disease and their parents regarding the exclusion diet,and to provide a basis for formulating personalized dietary guidance programs.Methods A total of 12 children with Crohn's disease and their parents,hospitalized in the Department of Gastroenterology at a tertiary children's hospital in Guangzhou from June to December 2023,were selected as research subjects using objective sampling.Semi-structured interviews were conducted,and the data were analyzed and refined using Colaizzi's seven-step analysis method.Results Totally 3 themes and 14 sub-themes were extracted.①Lack of cognition and trust in Crohn's disease exclusion diet(unfamiliarity with the contents of the diet,misunderstanding of the diet's preparation,inadequate response to daily exclusion diet practices,parents' distrust in the exclusion diet).②The practical challenges of the Crohn's disease exclusion diet(the challenge of personal dietary preferences,the challenge of family meal preparation,the challenge of school feeding,food intolerance,feelings of monotony and weariness following the exclusion diet).③Innovations in practicing the Crohn's disease exclusion diet(managing taste fatigue,managing visual fatigue,innovative cooking methods,prioritizing exclusive enteral nutrition followed by the exclusion diet,overcoming the desire for universal food).Conclusion Children with Crohn's disease and their parents exhibit insufficient cognition and trust in the exclusion diet and face various challenges in practice.Clinical medical staff should adopt personalized coping strategies tailored to the specific circumstances of each child.

Objective:To explore the correlation of bone metabolism with vitamin D and vitamin K levels in children with glucocorticoid-induced osteoporosis (GIOP) .Methods:A total of 120 GIOP children admitted to Neonatal Department of the First People’s Hospital of Chenzhou City, Hunan Province from Oct. 2022 to Dec. 2024 (GIOP group) and children without osteoporosis who received glucocorticoid therapy during the same period (the control group) were studied. Bone mineral density (BMD), biochemical indexes of bone metabolism and serum 25-hydroxyvitamin D (25 (OH) D), vitamin K1 (VitK1) and VitK2 were determined. BMD and bone metabolism indexes of GIOP children with different levels of 25 (OH) D, VitK1 and VitK2 were compared and their correlation was analyzed. Multiple linear regression analysis was conducted to analyze the independent factors affecting low BMD in GIOP children.Results:GIOP group had lower BMD, serum 25 (OH) D, VitK1 and VitK2 levels ( t=33.03, 42.22, 65.30, 86.16, P<0.05), while higher PINP, β-CTX and N-MID levels ( t=17.98, 34.78, 2.58, P<0.05); The levels of VitK1, VitK2, BMD, PINP, β-CTX and N-MID in GIOP children with different vitamin D and K levels were statistically significant ( F =54.31, 36.77, 82.32, 32.40, 22.80, 5.23), among which BMD was the lowest and PINP, β-CTX and N-MID levels were the highest ( P<0.05); The levels of 25 (OH) D, VitK1 and VitK2 were positively correlated with BMD ( r=0.54, 0.39, 0.47, P<0.05), but negatively correlated with PINP, β-CTX and N-MID ( r = -0.43, -0.34, -0.38, -0.39, -0.45, -0.44, -0.29, -0.32, -0.51, P<0.05); 25 (OH) D, VitK1 and VitK2 were protective factors for low BMD ( t=-2.76, -2.55, -3.51, P<0.05), while PINP, β-CTX, N-MID and hormone use time were risk factors ( t=2.48, 2.19, 2.22, 2.06, P<0.05) . Conclusions:The level of bone metabolism in children with GIOP is closely related to the levels of vitamin D and vitamin K. With the decrease of vitamin D and vitamin K levels, the decrease of BMD is more obvious. Therefore, vitamin D and vitamin K should be supplemented in a timely and reasonable manner for such children.

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 investigate the incidence of hip fracture among the elderly in communities,explore related influencing factors,and develop and validate a risk prediction model.Methods A stratified sampling method was used to collect sociodemographic data,lifestyles and risk factors in hip fracture between January 2023 and January 2024 among the elderly residents in communities in Deyang.With random splitting,479 elderly people(68.00%)were assigned to the model training set,and 221(32.00%)to the model validation set.In the model training set,the participants were divided into a fracture group and a non-fracture group based on hip fracture or not.Data from both groups were compared,and R software(version 4.3.1)was employed to develop and validate the risk prediction model.Results A total of 700 elderly residents in communities were included,62 of them had hip fracture within one year yielding a cumulative incidence rate of 8.86%.The risk prediction model identified six predictors:frequent consumption of preserved foods,daily exercise time,daily sunlight exposure,osteoporosis,times of fall within a year,and with≥20 pieces of natural teeth.In the training set,the model achieved an AUC of 0.945(95%CI:0.908-0.982),with a sensitivity of 88.89%and a specificity of 89.40%.The calibration curve demonstrated a good agreement between predicted and actual values,indicating a strong calibration.Decision curve analysis(DCA)showed a positive net benefit.In the validation set,the AUC was 0.892(95%CI:0.784-0.999),with a sensitivity of 82.35%and a specificity of 93.63%,confirming a good model fit and predictive performance.The calibration curve exhibited a strong consistency,and DCA indicated a positive net benefit.Conclusion The developed risk prediction model for hip fracture in elderly community residents demonstrates a strong predictive value.It provides a practical reference for community workers and healthcare professionals to screen and assess the risk of hip fracture among the elderly residents in communities.