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 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 short-term efficacy and safety of three dimensional (3D) brachytherapy with 192Ir under computed tomography (CT)-guidance in patients with locally advanced cervical carcinoma. Methods:A total of 82 patients with locally advanced cervical carcinoma,who admitted to the Department of Tumor Radiotherapy of the First Affiliated Hospital of Xi 'an Jiaotong University from October 2022 to October 2023,were selected,and they were divided into observation group and control group according to random number table method,with 41 cases in each group. The observation group received 3D brachytherapy with 192Ir under computed tomography (CT)-guidance,and control group received routine two-dimensional (2D) brachytherapy. The short-term efficacy,serum tumor markers,treatment safety and quality of life of the two groups were compared. Results:In observation group,the total effective rate was 97.56％,which was significantly higher than 80.49％ in control group (x2=6.116,P<0.05). The levels of glucose chain antigen 125 (CA125) and squamous cell carcinoma (SCC) antigen of serum tumor markers after treatment of observation group were significantly lower than those of control group (t=11.352,5.507,P<0.05),respectively. The incidences of radiation proctitis and radiation cystitis of observation group were respectively 7.32％ and 4.88％,which were significantly lower than 24.39％ and 21.95％ of control group (x2=4.479,5.143,P<0.05),respectively. After treatment,the scores of functional assessment of cancer therapy-cervix (FACT-Cx) scale (physiological status,social/family status,emotional status,functional status and additional concerns) of observation group were significantly higher than those of control group,and the differences of them between two groups were significantly (t=6.150,7426,9.341,10.029,8.623,P<0.05),respectively. Conclusion:3D brachytherapy with 192Ir under CT-guidance can achieve favorable short-term efficacy and higher safety on patients with locally advanced cervical carcinoma,which is helpful to further improve the quality of life of patients.

Objective:To investigate the short-term efficacy and safety of three dimensional (3D) brachytherapy with 192Ir under computed tomography (CT)-guidance in patients with locally advanced cervical carcinoma. Methods:A total of 82 patients with locally advanced cervical carcinoma,who admitted to the Department of Tumor Radiotherapy of the First Affiliated Hospital of Xi 'an Jiaotong University from October 2022 to October 2023,were selected,and they were divided into observation group and control group according to random number table method,with 41 cases in each group. The observation group received 3D brachytherapy with 192Ir under computed tomography (CT)-guidance,and control group received routine two-dimensional (2D) brachytherapy. The short-term efficacy,serum tumor markers,treatment safety and quality of life of the two groups were compared. Results:In observation group,the total effective rate was 97.56％,which was significantly higher than 80.49％ in control group (x2=6.116,P<0.05). The levels of glucose chain antigen 125 (CA125) and squamous cell carcinoma (SCC) antigen of serum tumor markers after treatment of observation group were significantly lower than those of control group (t=11.352,5.507,P<0.05),respectively. The incidences of radiation proctitis and radiation cystitis of observation group were respectively 7.32％ and 4.88％,which were significantly lower than 24.39％ and 21.95％ of control group (x2=4.479,5.143,P<0.05),respectively. After treatment,the scores of functional assessment of cancer therapy-cervix (FACT-Cx) scale (physiological status,social/family status,emotional status,functional status and additional concerns) of observation group were significantly higher than those of control group,and the differences of them between two groups were significantly (t=6.150,7426,9.341,10.029,8.623,P<0.05),respectively. Conclusion:3D brachytherapy with 192Ir under CT-guidance can achieve favorable short-term efficacy and higher safety on patients with locally advanced cervical carcinoma,which is helpful to further improve the quality of life of patients.

Radiotherapy is an effective anti-tumor therapy for different types of solid tumors. Over 50% of cancer patients are treated with radiotherapy at different stages in the course of the disease. According to traditional radiobiology, radiation therapy mainly kills tumor cells by causing proliferative death of tumor cells through DNA damage. However, clinical data showed that many patients still experienced tumor recurrence and metastasis after receiving radiation therapy. Current studies have found that the biological behavior of tumor cells, such as invasion and migration, were changed after radiation through epithelial-mesenchymal transition, circadian rhythm disruption, senescence, and increased stemness of cancer cells, thereby leading to tumor recurrence and metastasis. In this article, the changes and mechanisms of biological behavior in tumor cells after radiation were reviewed, providing evidence for the prevention and treatment of tumor recurrence and metastasis.

Objective:To evaluate the effects of occupational aluminum exposure on workers' overall cognitive function and cognitive fields.Methods:From July to August 2019, using the method of cluster sampling, 101 and 117 workers were selected from the electrolytic aluminum workshop of an aluminum plant in a region and the maintenance workshop of a plant in the same region. The venous blood of the subjects was collected, the plasma was extracted, and the blood aluminum concentration was measured by ICP-MS. According to the blood aluminum concentration and type of work, 93 workers who were lower than the median blood aluminum concentration and in the maintenance workshop of a factory were divided into low aluminum exposure group, and 85 workers who were higher than the median blood aluminum concentration and in the electrolytic aluminum workshop of an aluminum factory were divided into high aluminum exposure group. The basic information of the respondents, was collected through the employee physical examination form. The overall cognitive function of workers was evaluated by Beijing Montreal Cognitive Assessment Scale (MoCA) . Multiple linear regression analysis and logistic regression analysis were used for multiple statistical analysis.Results:Compared with the low aluminum exposure group (25.42±1.808) , the total score of MoCA in the high aluminum exposure group (23.84±2.919) was significantly lower, and the scores of visual space, executive function, abstract and delayed recall were significantly lower ( P<0.05) . Linear regression analysis showed that the total score of MoCA, visual space and executive function, naming and delayed recall were negatively correlated with blood aluminum concentration ( β=-0.018、-0.008、-0.003、-0.008, P<0.05) .MOCA total score, visual space and executive function, attention, language, abstraction, orientation were positively correlated with educational level ( β=0.853、0.310、0.216、0.171、0.412、0.122, P<0.05) . Logistic regression analysis showed that adjusting for age, smoking, drinking and education, blood aluminum was a risk factor for mild cognitive impairment ( OR=1.017, P<0.05) ; Education level was the protective factor of mild cognitive impairment ( OR=0.419, P<0.05) . Conclusion:Occupational aluminum exposure can affect the overall cognitive function of workers, and occupational aluminum exposure increases the risk of MCI.

Objective:To evaluate the effects of occupational aluminum exposure on workers' overall cognitive function and cognitive fields.Methods:From July to August 2019, using the method of cluster sampling, 101 and 117 workers were selected from the electrolytic aluminum workshop of an aluminum plant in a region and the maintenance workshop of a plant in the same region. The venous blood of the subjects was collected, the plasma was extracted, and the blood aluminum concentration was measured by ICP-MS. According to the blood aluminum concentration and type of work, 93 workers who were lower than the median blood aluminum concentration and in the maintenance workshop of a factory were divided into low aluminum exposure group, and 85 workers who were higher than the median blood aluminum concentration and in the electrolytic aluminum workshop of an aluminum factory were divided into high aluminum exposure group. The basic information of the respondents, was collected through the employee physical examination form. The overall cognitive function of workers was evaluated by Beijing Montreal Cognitive Assessment Scale (MoCA) . Multiple linear regression analysis and logistic regression analysis were used for multiple statistical analysis.Results:Compared with the low aluminum exposure group (25.42±1.808) , the total score of MoCA in the high aluminum exposure group (23.84±2.919) was significantly lower, and the scores of visual space, executive function, abstract and delayed recall were significantly lower ( P<0.05) . Linear regression analysis showed that the total score of MoCA, visual space and executive function, naming and delayed recall were negatively correlated with blood aluminum concentration ( β=-0.018、-0.008、-0.003、-0.008, P<0.05) .MOCA total score, visual space and executive function, attention, language, abstraction, orientation were positively correlated with educational level ( β=0.853、0.310、0.216、0.171、0.412、0.122, P<0.05) . Logistic regression analysis showed that adjusting for age, smoking, drinking and education, blood aluminum was a risk factor for mild cognitive impairment ( OR=1.017, P<0.05) ; Education level was the protective factor of mild cognitive impairment ( OR=0.419, P<0.05) . Conclusion:Occupational aluminum exposure can affect the overall cognitive function of workers, and occupational aluminum exposure increases the risk of MCI.

Objective: To determine the clinical application value of percutaneous lung biopsy guided by ultrasound in the diagnosis of peripheral lung lesions of silicosis. Methods: Experimental silicosis was produced in rabbits by the intratracheal administration of silica with non-exposure method. Imaging changes were observed in 36 rabbits on 60 days after intratracheal instillation of silica. To contrast with CT results, percutaneous lung biopsy of peripheral lesions was guided by ultrasound. The success rate of sufficient material, the diagnosis rate of coincidence between biopsy and pathology, and the incidence of complications were calculated. The biopsy with sufficient material, biopsy findings coincided with pathological results and no complications were defined as strictly success of the puncture. The baseline data and monitoring index were compared between successful biopsy group and unsuccessful biopsy group. Each rabbit was intravenously administrated by 10 000 U of heparin for the antiocoagulation and sacrificed by fast injection of 10% KCl through jugular vein catheterization. Specimens from lung tissue were collected and stained with hematoxylin-eosin. Pathological changes of lung tissue were observed through an optical microscope. Results: Of 36 silicosis rabbits, peripheral lung lesions of silicosis were observed in 30 rabbits. Biopsy procedures were performed with ultrasound guidance in 30 rabbits. The total success rate of biopsy was 70% (21/30). The success rate of sufficient material was 93% (28/30), the diagnosis rate of coincidence between biopsy and pathology 86%(24/28), and the incidence of complications was 10% (3/30) respectively. Compared with failure group, peripheral lesions in successful biopsy group were bigger in size, closer to the chest wall, and lower respiratory rate, the difference was statistically significant (P<0.05). There was no significant difference in weight, heart rate, temperature and stages of silicosis (P>0.05). The pathological results showed typical silicosis nodules. Silica-exposed rabbit also showed signs of vascular remodeling with pulmonary artery muscularization, vascular occlusion, and medial thickening. Conclusions Ultrasound-guided percutaneous lung biopsy is an effective and safe method in peripheral lung lesions of silicosis. It can serve as an important technical means to monitor the evolution of silicosis lesions and provide reference for the diagnosis of silicosis. Observation of small vascular changes in silicosis nodules by lung biopsy is helpful for clinical intervention treatment.

Objective: To analyze the current status of allergic adverse reactions caused by non-ionic iodinated contrast media in patients with coronary angiography (CAG).
Methods: A total of 1 225 patients who received non-ionic iodinated contrast media for CAG in our hospital from 2011-02 to 2013-09 were retrospectively studied. There were 52 patients suffered from allergic adverse reactions including 47 (90.38%) male and 5 (9.62%) female. The allergic reaction to iodixanol, iohexol, iopamidol and iopromide were in 34, 3, 3 and 12 patients respectively. The clinical symptoms and outcomes of allergic reaction in 4 iodinated contrast media were analyzed.
Results: There were 40/52 (76.92%) patients with mild allergic reaction, 11(21.15%) with moderate and 1 (1.92%) with severe reaction. 13 patients had the reaction within 1 hour of contrast media injection and 39 had the reaction between 1 hour to 3 days of contrast media injection. There 34 patients were cured by symptomatic and anti-allergic treatment, 1 patient was rescued from allergic shock and no death occurred.
Conclusion: Application of non-ionic iodinated contrast media in CAG is safe, while closely observe the allergic adverse reaction with the in time and symptomatic treatment is very important in clinical practice.

Objective To investigate the mRNA and protein expression of E3 ubiquitin ligase Iduna in non-small-cell lung cancer tissue and para-neoplastic lung tissue,and the correlation of the Iduna expression with clinicopathological factors and prognosis.Methods The expression levels of the Iduna mRNA and protein in non-small-cell lung cancer tissue and para-neoplastic lung tissue were determined by reverse transcriptase-polymerase chain reaction (RT-PCR),Western-Blot and immunohistochemistry respectively,and the correlation of the Iduna expression with clinicopathological factors and prognosis was analyzed.Results RT-PCR and Western-Blot showed the expression levels of the Iduna mRNA and protein in non-small-cell lung cancer tissue (0.468 ± 0.086 and 2.554 ± 0.544) were significantly higher than those in para-neoplastic lung tissue (0.203 ± 0.070 and 1.570 ± 0.316),there were statistical differences (P ＜ 0.05).Immunohistochemistry results showed that Iduna was negative expression in the alveolar epithelium cells,negative or weak positive expression in normal bronchial and positive expression in different degrees in the non-small-cell lung cancer tissue.Iduna high expression rate was negative correlation with tumor differentiation (P =0.002),Iduna high expression rate was positive correlation with large tumor size (P =0.044),TNM staging (P=0.015) and lymph node metastasis (P=0.009).Iduna high expression of I stage non-small-cell lung cancer patients was correlated with poor post-operative survival (P =0.016).Conclusions High expression of Iduna may be related to the process of invasion and metastasis of nonsmall-cell lung cancer.It is possible that Iduna serve as potential markers for predicting prognosis in nonsmall-cell lung cancer.