OBJECTIVE The aim of the study was to investigate and analyze the resource allocation and surveillance status of hospital-associated infections in secondary and above healthcare facilities in Anhui province.METHODS Secondary and above healthcare institutions in 16 cities were selected in Mar.2023 by convenient sampling meth-od,and self-designed questionnaire was administered by'wenjuanxing'to investigate the characteristics of health-care facilities,the management and surveillance of hospital-acquired infections.RESULTS A total of 302 medical facilities,including 88 tertiary and 195 comprehensive facilities,completed the survey.All tertiary healthcare fa-cilities set up the independent departments for hospital-associated infections,while 12.15%of secondary health-care facilities did not.Totally 17.22%of healthcare facilities did not meet the standard requirements of ratio of full-time equivalents to beds,while the unqualified rate of tertiary healthcare facilities(25.00%)was higher than that of secondary healthcare facilities(14.02%).The full-time equivalents were mainly in nursing(64.89%),and relatively insufficient in other specialties.All tertiary healthcare facilities had carried out comprehensive surveil-lance,however,secondary healthcare facilities still needed to be improved.The allocation ratio of surveillance in-formation for system hospital-associated infection was 37.42%in tertiary healthcare facilities,but only 18.69%in secondary.CONCLUSIONS The hospital-associated infection management system of certain healthcare facilities in Anhui province still calls for improving,more personnel numbers and specialties are required.Besides,the con-struction of information system urgently needs to be strengthened.At the same time,more attention should be paid to secondary healthcare facilities,which should be supplied for more resources,carry out basic monitoring work to reduce hospital-associated infections and ensure patients'safety.

OBJECTIVE To evaluate the changes in monitoring indicators related to healthcare-associated infections(HAIs)management in Anhui Province in 2018 and 2022,to provide a scientific basis for optimizing HAI control strategies.METHODS A cross-sectional survey was conducted in 2019 and 2023 across 48 secondary and tertia-ry medical institutions,HAI data were collected and analyzed.RESULTS The two-year averages of monitoring indi-cators were as follows:the incidence rate of HAIs was 0.66％,the prevalence rate of HAIs was 1.69％,the inci-dence rate of surgical site infection for class I incisions was 0.20％,the antibiotic usage rate was 44.59％,the pathogen detection rate for therapeutic antibiotics was 43.76％,the incidence rate of catheter-related blood-stream infection(CRBSI)was 0.64‰,the incidence rate of ventilator-associated pneumonia(VAP)was 5.81‰,and the incidence rate of catheter-associated urinary tract infection(CAUTI)was 0.79‰.By 2022,significant im-provements were observed in most indicators(P＜0.05).Compared to tertiary hospitals,secondary hospitals ex-hibited low rates of hospital infection incidence,prevalence,class I incision infections,antibiotic utilization and CRBSI,but high rates of VAP and CAUTI(P＜0.05).CONCLUSIONS Significant improvements have been made in monitoring indicators related to HAI managements in Anhui Province.However,secondary hospitals still need to enhance their capabilities of monitoring indicators and detecting pathogens.

Objective To evaluate the effectiveness of active screening in improving the detection rate of carbape-nem-resistant Enterobacterales(CRE)in the intensive care units(ICUs).Methods From July 2023 to June 2024,active screening of rectal swab CRE was conducted on ICU patients in 10 hospitals.ICU patients who underwent ac-tive screening from July 2023 to June 2024 were selected as the study group,while those who did not undergo active screening from July 2022 to June 2023 were selected as the control group.Difference in CRE detection rates between the two groups of patients was compared.Results A total of 7 803 ICU patients were included in the study group,744 CRE strains were detected,with a detection rate of 9.53％,out of which 304 CRE strains were detected through routine detection(detection rate 3.90％),3 707 patients underwent active screen,440 CRE strains were detected(detection rate 11.87％).7 561 ICU patients were included in the control group,out of which 250 CRE strains were detected through routine detection,with a detection rate of 3.31％.There was a statistically significant difference in the overall detection rate of CRE between two groups of patients(x2=246.18,P＜0.001).In the study group,CRE detection rate of active screening(11.87％)was higher than that of routine detection(3.90％),with statistically significant difference(x2=264.26,P＜0.001).A total of 17 CRE strains were detected from the study group.The proportions of Klebsiella pneumoniae(80.92％vs 73.41％)and Serratia marcescens(2.30％vs0.23％)in the routine detection group were both higher than in the active screening group,while the proportion of Escherichia coli in the routine detection group was lower(8.22％vs 19.55％),all with statistically significant differences(all P＜0.05).Conclusion The prevalence of CRE in ICUs is relatively high,with a wide range of bac-terial species.Active screening can improve the detection rate of CRE.

ObjectiveTo investigate the association between cumulative atherogenic index of plasma （cumAIP） and the risk of new-onset nonalcoholic fatty liver disease （NAFLD） in young and middle-aged individuals. MethodsA prospective cohort study was conducted among the young and middle-aged individuals （aged 18 to <60 years） in the Kailuan study cohort who underwent physical examination in Kailuan General Hospital and its 10 affiliated hospitals in June 2006 to October 2010， and after screening based on the inclusion and exclusion criteria， 33 987 individuals were included in the observation cohort. The individuals were divided into Q1， Q2， Q3， and Q4 groups based on the quantiles of cumAIP. The Kaplan-Meier method was used to calculate the cumulative incidence rate of new-onset NAFLD in the four groups， while the log-rank test was used for comparison between groups. A multivariate Cox regression analysis was used to obtain the hazard ratio （HR） and 95% confidence interval （CI） of the risk of new-onset NAFLD in the four groups. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups， and the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups； the chi-square test was used for comparison of categorical variables between groups. ResultsThe mean follow-up was 10.89±2.54 years， and there were 6 011 cases of new-onset NAFLD， including 995 cases in the Q1 group， 1 366 in the Q2 group， 1661 in the Q3 group， and 1 989 in the Q4 group， with an incidence density of 11.37， 16.02， 19.97， and 24.91 per thousand person-years. The log-rank test showed that there was a significant difference in cumulative incidence rate between the four groups （P<0.001）. With the presence or absence of NAFLD as the dependent variable and the quantiles of different exposure levels to cumAIP as the independent variable， the multivariate Cox regression model analysis showed that compared with the Q1 group， the Q2， Q3， and Q4 groups had an HR of 1.30 （95%CI： 1.20 — 1.41）， 1.52 （95%CI： 1.41 — 1.65）， and 1.79 （95%CI： 1.64 — 1.95）， respectively， for new-onset NAFLD， with a P_trend value of <0.001. With the presence or absence of new-onset NAFLD as the dependent variable and the cumulative exposure to AIP for 0， 2， 4， and 6 years as the independent variable， the Cox regression analysis showed that compared with cumulative exposure to AIP for 0 years， cumulative exposure to AIP for 2， 4， and 6 years had an HR of 1.24 （95%CI： 1.15 — 1.35）， 1.51 （95%CI： 1.40 — 1.64）， and 1.70 （95%CI： 1.56 — 1.84）， respectively， with a P_trend value of <0.001. A sensitivity analysis was performed after exclusion of the individuals with new-onset NAFLD within 2 years， the individuals who experienced atherosclerotic cardiovascular disease events during follow-up， and the individuals taking antihypertensive， hypoglycemic， and lipid-lowering drugs， and the results were similar to those of the main analysis. Considering the competitive relationship between all-cause death and outcome events， a competing risk analysis of death was performed， which showed that the results of risk analysis were similar to those of the main analysis. ConclusionA high level of cumAIP exposure can increase the risk of new-onset NAFLD in young and middle-aged individuals.

Objective To evaluate the effectiveness of active screening in improving the detection rate of carbape-nem-resistant Enterobacterales(CRE)in the intensive care units(ICUs).Methods From July 2023 to June 2024,active screening of rectal swab CRE was conducted on ICU patients in 10 hospitals.ICU patients who underwent ac-tive screening from July 2023 to June 2024 were selected as the study group,while those who did not undergo active screening from July 2022 to June 2023 were selected as the control group.Difference in CRE detection rates between the two groups of patients was compared.Results A total of 7 803 ICU patients were included in the study group,744 CRE strains were detected,with a detection rate of 9.53％,out of which 304 CRE strains were detected through routine detection(detection rate 3.90％),3 707 patients underwent active screen,440 CRE strains were detected(detection rate 11.87％).7 561 ICU patients were included in the control group,out of which 250 CRE strains were detected through routine detection,with a detection rate of 3.31％.There was a statistically significant difference in the overall detection rate of CRE between two groups of patients(x2=246.18,P＜0.001).In the study group,CRE detection rate of active screening(11.87％)was higher than that of routine detection(3.90％),with statistically significant difference(x2=264.26,P＜0.001).A total of 17 CRE strains were detected from the study group.The proportions of Klebsiella pneumoniae(80.92％vs 73.41％)and Serratia marcescens(2.30％vs0.23％)in the routine detection group were both higher than in the active screening group,while the proportion of Escherichia coli in the routine detection group was lower(8.22％vs 19.55％),all with statistically significant differences(all P＜0.05).Conclusion The prevalence of CRE in ICUs is relatively high,with a wide range of bac-terial species.Active screening can improve the detection rate of CRE.

OBJECTIVE The aim of the study was to investigate and analyze the resource allocation and surveillance status of hospital-associated infections in secondary and above healthcare facilities in Anhui province.METHODS Secondary and above healthcare institutions in 16 cities were selected in Mar.2023 by convenient sampling meth-od,and self-designed questionnaire was administered by'wenjuanxing'to investigate the characteristics of health-care facilities,the management and surveillance of hospital-acquired infections.RESULTS A total of 302 medical facilities,including 88 tertiary and 195 comprehensive facilities,completed the survey.All tertiary healthcare fa-cilities set up the independent departments for hospital-associated infections,while 12.15%of secondary health-care facilities did not.Totally 17.22%of healthcare facilities did not meet the standard requirements of ratio of full-time equivalents to beds,while the unqualified rate of tertiary healthcare facilities(25.00%)was higher than that of secondary healthcare facilities(14.02%).The full-time equivalents were mainly in nursing(64.89%),and relatively insufficient in other specialties.All tertiary healthcare facilities had carried out comprehensive surveil-lance,however,secondary healthcare facilities still needed to be improved.The allocation ratio of surveillance in-formation for system hospital-associated infection was 37.42%in tertiary healthcare facilities,but only 18.69%in secondary.CONCLUSIONS The hospital-associated infection management system of certain healthcare facilities in Anhui province still calls for improving,more personnel numbers and specialties are required.Besides,the con-struction of information system urgently needs to be strengthened.At the same time,more attention should be paid to secondary healthcare facilities,which should be supplied for more resources,carry out basic monitoring work to reduce hospital-associated infections and ensure patients'safety.

OBJECTIVE To evaluate the changes in monitoring indicators related to healthcare-associated infections(HAIs)management in Anhui Province in 2018 and 2022,to provide a scientific basis for optimizing HAI control strategies.METHODS A cross-sectional survey was conducted in 2019 and 2023 across 48 secondary and tertia-ry medical institutions,HAI data were collected and analyzed.RESULTS The two-year averages of monitoring indi-cators were as follows:the incidence rate of HAIs was 0.66％,the prevalence rate of HAIs was 1.69％,the inci-dence rate of surgical site infection for class I incisions was 0.20％,the antibiotic usage rate was 44.59％,the pathogen detection rate for therapeutic antibiotics was 43.76％,the incidence rate of catheter-related blood-stream infection(CRBSI)was 0.64‰,the incidence rate of ventilator-associated pneumonia(VAP)was 5.81‰,and the incidence rate of catheter-associated urinary tract infection(CAUTI)was 0.79‰.By 2022,significant im-provements were observed in most indicators(P＜0.05).Compared to tertiary hospitals,secondary hospitals ex-hibited low rates of hospital infection incidence,prevalence,class I incision infections,antibiotic utilization and CRBSI,but high rates of VAP and CAUTI(P＜0.05).CONCLUSIONS Significant improvements have been made in monitoring indicators related to HAI managements in Anhui Province.However,secondary hospitals still need to enhance their capabilities of monitoring indicators and detecting pathogens.

Objective To study the effect of parecoxib sodium on tumor microenvironment in patients undergoing laparoscopic radical resection of rectal cancer.Methods Sixty patients undergoing laparoscopic surgery for radical rectal cancer resection were randomized into test group and control group(n=30).The patients in test control group received intravenous injections of 40 mg parecoxib sodium at the time of anesthesia induction,immediately after and at 12 h after the surgery,and those in the control group were injected with an equal volume of physiological saline at the same time points.Plasma levels of IL-6,TNF-α,and CXCL8 of the patients were measured using ELISA,and expressions of CXCL8,CXCR1,and CXCR2 in the peripheral blood mononuclear cells(PBMCs)were detected with Western blotting.Postoperative VAS scores and gastrointestinal reactions and disease regression at 6 months after the operation were recorded.Results Compared with the control patients,the patients in the test group showed significantly reduced plasma levels of IL-6,TNF-α,and CXCL8(P<0.05)and milder elevations of CXCL8,CXCR1,and CXCR2 proteins in PBMCs(P<0.05)with significantly lower VAS scores at 12 h and 24 h after the operation(P<0.05)and lower postoperative incidence of adverse gastrointestinal reactions(P<0.05).At 6 months after the operation,the number of patients with metastasis or tumor recurrence was significantly smaller in the test group than in the control group(P>0.05).Conclusion Parecoxib sodium can improve the inflammatory microenvironment to promote patient recovery after laparoscopic radical resection of rectal cancer possibly through a mechanism that down-regulates CXCL8-CXCR1/2 expressions in the PBMCs.

Objective To establish a mouse model of pregnancy pain-depression comorbidity induced by chronic unpredictable stress(CUS),complete Freund's adjuvant(CFA),and formalin,and to systematically evaluate the associated phenotypes and preliminarily explore the pathological basis of the comorbidity.Methods Eight-week-old C57BL/6J female mice were randomly strarified divided into a control group(no intervention before pregnancy)and a CUS model group(CUS intervention before pregnancy)based on sucrose preference test(SPT)data.After completing the CUS treatment,female and male mice were paired and mated.Pain was induced by injecting 50％CFA and 5％formalin in the right hind foot during pregnancy to create a model of pregnancy pain-depression comorbidity.The experiment was divided into 8 subgroups:control-blank group,CUS-blank group,control-CFA group,CUS-CFA group,control-formalin group,CUS-formalin group,control-CFA+formalin group,and CUS-CFA+formalin group,with 10 mice in each group.The mice in each group were subject to behavioral tests,including the SPT,forced swimming test,tail suspension test,and open field test before and after CUS intervention,during pregnancy,and after delivery.Pain sensitivity changes were measured using mechanical allodynia and thermal hyperalgesia tests.Mice were then euthanized.Levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in hippocampus,as well as cortisol and adrenocorticotropic hormone(ACTH)in serum,were detected by enzyme-linked immunosorbent assay(ELISA).Results Compared with the control-blank group,the CUS-blank group showed a significant depression-like behavior with reduced pain threshold(P＜0.001).The control-CFA+formalin group showed a decrease in pain threshold after both CFA injection and formalin injection(P＜0.01).Compared with the control-blank and control-formalin groups,the pain threshold was significantly lower in the CUS-formalin group(P＜0.01),with a sequential decrease among the three.Compared with the control-blank and control-CFA groups,the pain threshold was significantly lower in the CUS-CFA group(P＜0.001),with a sequential decrease among the three.Compared with the control-blank and control-CFA+formalin groups,the mechanical pain threshold of mice in the CUS-CFA+formalin group was significantly lower(P＜0.001)and the thermal radiation tolerance time was shorter(P＜0.01),both with sequential decreases among the three.Compared with the control-CFA+formalin and the CUS-blank groups,the CUS-CFA+formalin group had a significantly lower percentage of sucrose preference(P＜0.001),longer immobility time during the forced swimming test(P＜0.001)and tail suspension test(P＜0.001),reduced central exploration time in the open field test(P＜0.001),reduced total exploration distance(P＜0.001),and reduced percentage of distance traveled for central exploration(P＜0.001).Compared with the control-CFA+formalin and CUS-blank groups,the serum cortisol and ACTH levels of the CUS-CFA+formalin group were significantly higher(P＜0.01),and the levels of IL-6 and TNF-α in the hippocampus were higher(P＜0.05).Conclusion The combination of CUS+CFA+formalin injections is an ideal method for establishing a C57BL/6J mouse model of pregnancy pain-depression comorbidity.The behavioral changes in model mice may be attributed to the regulation of inflammatory response in hippocampus and hormone levels in the hypothalamic-pituitary-adrenal(HPA)axis.

Objective To study the effect of parecoxib sodium on tumor microenvironment in patients undergoing laparoscopic radical resection of rectal cancer.Methods Sixty patients undergoing laparoscopic surgery for radical rectal cancer resection were randomized into test group and control group(n=30).The patients in test control group received intravenous injections of 40 mg parecoxib sodium at the time of anesthesia induction,immediately after and at 12 h after the surgery,and those in the control group were injected with an equal volume of physiological saline at the same time points.Plasma levels of IL-6,TNF-α,and CXCL8 of the patients were measured using ELISA,and expressions of CXCL8,CXCR1,and CXCR2 in the peripheral blood mononuclear cells(PBMCs)were detected with Western blotting.Postoperative VAS scores and gastrointestinal reactions and disease regression at 6 months after the operation were recorded.Results Compared with the control patients,the patients in the test group showed significantly reduced plasma levels of IL-6,TNF-α,and CXCL8(P<0.05)and milder elevations of CXCL8,CXCR1,and CXCR2 proteins in PBMCs(P<0.05)with significantly lower VAS scores at 12 h and 24 h after the operation(P<0.05)and lower postoperative incidence of adverse gastrointestinal reactions(P<0.05).At 6 months after the operation,the number of patients with metastasis or tumor recurrence was significantly smaller in the test group than in the control group(P>0.05).Conclusion Parecoxib sodium can improve the inflammatory microenvironment to promote patient recovery after laparoscopic radical resection of rectal cancer possibly through a mechanism that down-regulates CXCL8-CXCR1/2 expressions in the PBMCs.