OBJECTIVE To investigate the current status of cleaning and disinfection of medical bedding items in public medical institutions of Liangshan ethnic minority area and analyze the risk of infections so as to provide ba-ses for optimizing the infection control strategies in the ethnic minority area.METHODS On the basis of question-naire survey,onsite sampling method and bacterial isolation and identification technique,a cross-sectional survey was conducted for the current status of cleaning and disinfection of medical bedding items in 15 different grades of public medical institutions of Liangshan ethnic minority area by stratified random sampling method from Sep.2021 to Sep.2023.RESULTS A total of 66 valid questionnaire were recycled,and 540 bedding item samples were col-lected.Totally 93.33％of the medical institutions relied on laundries for centralized cleaning of the medical bed-ding items.The implementation rates of management items such as policy formulation(100.00％)and pre-job training were remarkably higher in the tertiary hospitals than in the secondary and primary hospitals(allP＜0.05).There were no significant differences in the qualified rates of surveillance of microbiological indexes for the medical bedding items among the medical institutions,the qualified rate of surveillance of microbiological inde-xes was highest(71.30％)in the general hospitals and was lowest(61.11％)in the infectious diseases specialized hospital.The qualified rate of surveillance of microbiological indexes was lowest(3.33％)in pediatrics department or internal medicine department,and it raised most remarkably(80.00％)after the disinfection,and there was significant difference(x2=36.274,P＜0.001).CONCLUSIONS The current status of disinfection of the medical bedding items is not optimistic in the medical institutions of Liangshan ethnic minority area.There are the prob-lems such as imperfect system,insufficient equipment and absence of personnel training.It is necessary to com-plete the execution and supervision system for cleaning and disinfection standards,increase the cleaning facilities,promote the use of antibacterial textile and bring in smart management system so as to improve the cleaning and disinfection quality and reduce the risk of hospital-associated infections.

Objective To establish an inductively coupled plasma-mass spectrometry(ICP-MS)method for the analysis of 29 mineral elements in Artemisiae Argyi Folium(AAF),and to develop a model for judging the origin of AAF based on the elemental fingerprint combined with chemometrics.Methods The variance method was used to compare the contents of 29 mineral elements in AAF samples from Qichun of Hubei province,Hebei province and Henan province,respectively.The discriminant models of AAF from different habitats were established by discriminant analysis,PLS-DA and PCA-Logistic regression algorithms.Results The differences of the 22 elements(V,Cr,Ni,As,Se,Rb,Mo,Cd,Sb,Ba,Hg,Pb,K,Li,B,Mg,Al,P,Ca,Fe,Zn,and Ga)in samples from Qichun of Hubei province,Hebei province and Henan province are extremely significant(P＜0.01).The discriminant analysis model showed that eight kinds of element variables(P,Cr,K,Li,Hg,Ba,Mg,and Mo),which have a significant effect on the origin discrimination are gradually introduced into the discriminant model,and the correct rate of back test is 100％.The correct rate of"leave one method"cross-validation is 96.7％.The PLS-DA model showed good prediction ability,and the variable importance projection values of K,P and Mg elements were greater than one,which could be used as the difference marker of AAF from different habitats.The accuracy of the origin discrimination model constructed by PC A-Logistic regression analysis was 100％.The elements with high first principal component loadings were Li,B,Mg,Al,P,K,Ca,V,Cr,Fe,Ni,Zn,As,Rb,Cd,Sb,and Ba.Conclusion This study shows that elemental fingerprint technology combined with chemometric analysis can identify AAF from Qichun of Hubei province,Hebei province,or Henan,providing technical support for the traceability of the origin of Artemisia argyi.

Objective To investigate the relationship between traditional Chinese medicine(TCM)syndromes and triacylglyceride-glucose(TyG)index in diabetic retinopathy(DR).Methods A total of 185 DR patients hospitalized in Jiangsu Provincial Hospital of Traditional Chinese Medicine from January to October 2019 were classified by TCM syndromes differentiation,the differences in clinical data of patients with different TCM syndromes were compared,and the correlation between each TCM syndromes and TyG index was ana-lyzed by Logistic regression.Results The distribution of the 185 DR patients was 32 cases(17.3％)with syndrome of yin deficiency and internal heat,61 cases(33.0％)with syndrome of qi-yin deficiency,35 cases(18.9％)with syndrome of liver-kidney deficien-cy,28 cases(15.1％)with syndrome of spleen deficiency and dampness retention,and 29 cases(15.7％)with syndrome of yin-yang deficiency.Statistically significant differences were observed in TyG index,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),triglyceride(TG),and high-density lipoprotein cholesterol(HDL-C)among different syndromes(P＜0.05).Patients with syndrome of spleen deficiency and dampness retention had significantly higher TyG index and TG levels than those in the other four groups(P＜0.05).FBG levels in patients with syndrome of qi-yin deficiency and syndrome of spleen deficiency and dampness retention were higher than those in patients with syndrome of yin-yang deficiency(P＜0.05).HbA1c levels in patients with syndrome of qi-yin deficiency were significantly higher than those in the other four groups(P＜0.05).HDL-C levels in the spleen deficiency with damp-ness stagnation group were lower than those in the qi-yin deficiency group,and HDL-C levels in the yin-yang deficiency group were lower than those in the liver-kidney deficiency group(P＜0.05).The results of Logistic regression analysis showed that the TyG index was positively correlated with syndrome of spleen deficiency and dampness retention,and served as an independent risk factor for this syn-drome.Conclusion The most common TCM syndrome in DR patients is syndrome of qi-yin deficiency.The TyG index is highest in pa-tients with syndrome of spleen deficiency and dampness retention,indicating its potential as an objective auxiliary indicator for TCM syn-drome differentiation in DR.

OBJECTIVE To investigate the current status of cleaning and disinfection of medical bedding items in public medical institutions of Liangshan ethnic minority area and analyze the risk of infections so as to provide ba-ses for optimizing the infection control strategies in the ethnic minority area.METHODS On the basis of question-naire survey,onsite sampling method and bacterial isolation and identification technique,a cross-sectional survey was conducted for the current status of cleaning and disinfection of medical bedding items in 15 different grades of public medical institutions of Liangshan ethnic minority area by stratified random sampling method from Sep.2021 to Sep.2023.RESULTS A total of 66 valid questionnaire were recycled,and 540 bedding item samples were col-lected.Totally 93.33％of the medical institutions relied on laundries for centralized cleaning of the medical bed-ding items.The implementation rates of management items such as policy formulation(100.00％)and pre-job training were remarkably higher in the tertiary hospitals than in the secondary and primary hospitals(allP＜0.05).There were no significant differences in the qualified rates of surveillance of microbiological indexes for the medical bedding items among the medical institutions,the qualified rate of surveillance of microbiological inde-xes was highest(71.30％)in the general hospitals and was lowest(61.11％)in the infectious diseases specialized hospital.The qualified rate of surveillance of microbiological indexes was lowest(3.33％)in pediatrics department or internal medicine department,and it raised most remarkably(80.00％)after the disinfection,and there was significant difference(x2=36.274,P＜0.001).CONCLUSIONS The current status of disinfection of the medical bedding items is not optimistic in the medical institutions of Liangshan ethnic minority area.There are the prob-lems such as imperfect system,insufficient equipment and absence of personnel training.It is necessary to com-plete the execution and supervision system for cleaning and disinfection standards,increase the cleaning facilities,promote the use of antibacterial textile and bring in smart management system so as to improve the cleaning and disinfection quality and reduce the risk of hospital-associated infections.

Objective To establish an inductively coupled plasma-mass spectrometry(ICP-MS)method for the analysis of 29 mineral elements in Artemisiae Argyi Folium(AAF),and to develop a model for judging the origin of AAF based on the elemental fingerprint combined with chemometrics.Methods The variance method was used to compare the contents of 29 mineral elements in AAF samples from Qichun of Hubei province,Hebei province and Henan province,respectively.The discriminant models of AAF from different habitats were established by discriminant analysis,PLS-DA and PCA-Logistic regression algorithms.Results The differences of the 22 elements(V,Cr,Ni,As,Se,Rb,Mo,Cd,Sb,Ba,Hg,Pb,K,Li,B,Mg,Al,P,Ca,Fe,Zn,and Ga)in samples from Qichun of Hubei province,Hebei province and Henan province are extremely significant(P＜0.01).The discriminant analysis model showed that eight kinds of element variables(P,Cr,K,Li,Hg,Ba,Mg,and Mo),which have a significant effect on the origin discrimination are gradually introduced into the discriminant model,and the correct rate of back test is 100％.The correct rate of"leave one method"cross-validation is 96.7％.The PLS-DA model showed good prediction ability,and the variable importance projection values of K,P and Mg elements were greater than one,which could be used as the difference marker of AAF from different habitats.The accuracy of the origin discrimination model constructed by PC A-Logistic regression analysis was 100％.The elements with high first principal component loadings were Li,B,Mg,Al,P,K,Ca,V,Cr,Fe,Ni,Zn,As,Rb,Cd,Sb,and Ba.Conclusion This study shows that elemental fingerprint technology combined with chemometric analysis can identify AAF from Qichun of Hubei province,Hebei province,or Henan,providing technical support for the traceability of the origin of Artemisia argyi.

Objective To investigate the relationship between traditional Chinese medicine(TCM)syndromes and triacylglyceride-glucose(TyG)index in diabetic retinopathy(DR).Methods A total of 185 DR patients hospitalized in Jiangsu Provincial Hospital of Traditional Chinese Medicine from January to October 2019 were classified by TCM syndromes differentiation,the differences in clinical data of patients with different TCM syndromes were compared,and the correlation between each TCM syndromes and TyG index was ana-lyzed by Logistic regression.Results The distribution of the 185 DR patients was 32 cases(17.3％)with syndrome of yin deficiency and internal heat,61 cases(33.0％)with syndrome of qi-yin deficiency,35 cases(18.9％)with syndrome of liver-kidney deficien-cy,28 cases(15.1％)with syndrome of spleen deficiency and dampness retention,and 29 cases(15.7％)with syndrome of yin-yang deficiency.Statistically significant differences were observed in TyG index,fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),triglyceride(TG),and high-density lipoprotein cholesterol(HDL-C)among different syndromes(P＜0.05).Patients with syndrome of spleen deficiency and dampness retention had significantly higher TyG index and TG levels than those in the other four groups(P＜0.05).FBG levels in patients with syndrome of qi-yin deficiency and syndrome of spleen deficiency and dampness retention were higher than those in patients with syndrome of yin-yang deficiency(P＜0.05).HbA1c levels in patients with syndrome of qi-yin deficiency were significantly higher than those in the other four groups(P＜0.05).HDL-C levels in the spleen deficiency with damp-ness stagnation group were lower than those in the qi-yin deficiency group,and HDL-C levels in the yin-yang deficiency group were lower than those in the liver-kidney deficiency group(P＜0.05).The results of Logistic regression analysis showed that the TyG index was positively correlated with syndrome of spleen deficiency and dampness retention,and served as an independent risk factor for this syn-drome.Conclusion The most common TCM syndrome in DR patients is syndrome of qi-yin deficiency.The TyG index is highest in pa-tients with syndrome of spleen deficiency and dampness retention,indicating its potential as an objective auxiliary indicator for TCM syn-drome differentiation in DR.

Bluetongue virus is an arbovirus that seriously harms ruminants such as sheep,this study aims to investigate the molecular mechanism of bluetongue virus infection and host cell interferon antiviral immune response.The study was conducted to characterize the mRNA expression of inter-feron pathway genes by real-time fluorescence quantitative PCR,as well as Western blot analysis of MDA5,TRAF3,RIG-Ⅰ,and TBK1 protein expression in BHK-21 cells induced by BTV with a multiplicity of infections(MOI)of 1 for 18,24,and 36 h.The results showed that the most pro-nounced changes in the expression of interferon signaling pathway genes were observed at 24 h of induction,the gene mRNA expression levels of the IFN-α,IFN-β,RIG-Ⅰ,TBK1,MDA5,VISA,and TRAF3 genes were upregulated.However,the mRNA expression levels of IKKε and TRAF6 genes were downregulated.At the protein level,MDA5 and TBK1 proteins were upregulated while RIG-1 and TRAF3 proteins were downregulated,which showed that BTV infection induces a typeⅠ interferon immune response in BHK-21 cells.This study lays the foundation for further exploring the antiviral immunity mechanism of IFN-Ⅰ signaling pathway regulatory genes in host cells infected with BTV infection.

Aim To investigate the clinical efficacy and preliminary mechanism of Yiqi Huoxue Jiangzhuo decoc-tion combined with butylphthalide in the treatment of transient ischemic attack(TIA).Methods A total of 120 pa-tients with TIA admitted to the First People's Hospital of Nanyang from January 2022 to March 2023 were selected as the re-search subjects and randomly divided into three groups with 40 cases in each group.The control group 1 was given bu-tylphthalide,the control group 2 was given Yiqi Huoxue Jiangzhuo decoction,and the observation group was given Yiqi Huoxue Jiangzhuo decoctionn combined with butylphthalide for 2 months of treatment.After 2 months of treatment,the clinical efficacy and adverse reaction rate were compared among the three groups.The ABCD2 scores,national institute of health stroke scale(NIHSS)scores,and serum biochemical indicators(soluble CD40 ligand(sCD40L),lipoprotein-asso-ciated phospholipase A2(Lp-PLA2),high-sensitive C-reactive protein(hs-CRP)),peripheral blood Kelch-like epichlo-rohydrin-related protein-1(Keap1)-nuclear factor E2-related factor 2(Nrf2)/antioxidant response element(ARE)signa-ling pathway-related protein levels(Keap1,Nrf2,ARE),and hemodynamic indicators(mean blood flow velocity(Vm),mean blood flow volume(Qm),cerebral vascular resistance(R))were compared before treatment and at 1 and 2 months after treatment in the three groups.Results The total clinical efficacy rate in observation group was significantly higher than that in control group 1 and control group 2(P＜0.05),but there was no significant difference between the two control groups(P＞0.05).Compared with before treatment,the ABCD2 scores and NIHSS scores in the three groups showed a significant downward trend after 1 month and 2 months of treatment,and the decrease in observation group was larger than that in control group 1 and control group 2(P＜0.05),but there was no significant difference between the two control groups(P＞0.05).Compared with before treatment,sCD40L,Lp-PLA2,and hs-CRP in the three groups showed a significant downward trend after 1 month and 2 months of treatment,and the decrease in observation group was larger than that in control group 1 and control group 2(P＜0.05).Compared with before treatment,Keap1 protein in the three groups showed a significant downward trend after 1 month and 2 months of treatment,and the decrease in observation group was larger than that in control group 1 and control group 2(P＜0.05),but there was no significant difference between the two control groups(P＞0.05).Compared with before treatment,the Nrf2 protein and ARE protein in the three groups showed a significant increase trend after 1 month and 2 months of treatment,and the increase amplitude in observation group was larger than that in control group 1 and control group 2(P＜0.05),but there was no significant difference be-tween the two control groups(P＞0.05).Compared with before treatment,Qm,Vm of the three groups increased and R decreased significantly at 1 month and 2 months after treatment,and the Qm,Vm in observation group were significantly higher than that in control group 1 and control group 2,while R was significantly lower than that in control group 1 and con-trol group 2(P＜0.05).Conclusion Yiqi Huoxue Jiangzhuo decoction combined with butylphthalide is more effective than butylphthalide and Yiqi Huoxue Jiangzhuo decoction alone in treating TIA,can improve neurological function,cerebral hemodynamics,inhibit inflammatory response,and has a certain degree of safety,and its mechanism of action is related to the regulation of Keap1-Nrf2/ARE signaling pathway.

ObjectiveTo investigate the influencing factors for the clinical outcome of patients with drug-induced liver injury （DILI）， and to establish a nomogram prediction model for validation. MethodsA retrospective analysis was performed for the general information and laboratory data of 188 patients with DILI who were admitted to Heilongjiang Provincial Hospital Affiliated to Harbin Institute of Technology from January 2017 to December 2022， and according to their clinical outcome， they were divided into good outcome group with 146 patients and poor outcome group with 42 patients. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test was used for comparison of categorical data between two groups. Univariate and multivariate Logistic regression analyses were used to investigate the independent influencing factors for the clinical outcome of DILI patients. R Studio 4.1.2 software was used to establish a nomogram model， and calibration curve， receiver operating characteristic （ROC） curve， and decision curve analysis （DCA） were used to perform internal validation. ResultsThe univariate Logistic regression analysis showed that liver biopsy for the diagnosis of DILI， platelet count， cholinesterase， albumin， prothrombin time activity， IgM， and IgG were associated with adverse outcomes in patients with DILI. The multivariate Logistic regression analysis showed that liver biopsy for the diagnosis of DILI （odds ratio ［OR］=0.072， 95% confidence interval ［CI］： 0.022‍ ‍—‍ ‍0.213， P<0.001）， clinical classification （OR=0.463， 95%CI： 0.213‍ ‍—‍ ‍0.926， P=0.039）， alanine aminotransferase （OR=0.999， 95%CI： 0.998‍ ‍—‍ ‍1.000， P=0.025）， prothrombin time activity （OR=0.973， 95%CI： 0.952‍ ‍—‍ ‍0.993， P=0.011）， and IgM （OR=1.456， 95%CI： 1.082‍ ‍—‍ ‍2.021， P=0.015） were independent influencing factors for clinical outcome in patients with DILI. The nomogram prediction model was established， and after validation， the calibration curve was close to the reference curve. The area under the ROC curve was 0.829， and the DCA curve showed that the model had good net clinical benefit. ConclusionThe nomogram prediction model established in this study has good clinical calibration， discriminative ability， and application value in evaluating the clinical outcome of patients with DILI.

The COVID-19 epidemic has spread to the whole world for three years and has had a serious impact on human life, health and economic activities. China's epidemic prevention and control has gone through the following stages: emergency unconventional stage, emergency normalization stage, and the transitional stage from the emergency normalization to the "Category B infectious disease treated as Category B" normalization, and achieved a major and decisive victory. The designated hospitals for prevention and control of COVID-19 epidemic in Tianjin has successfully completed its tasks in all stages of epidemic prevention and control, and has accumulated valuable experience. This article summarizes the experience of constructing a hospital infection prevention and control system during the "Category B infectious disease treated as Category A" period in designated hospital. The experience is summarized as the "Cluster" hospital infection prevention and control system, namely "three rings" outside, middle and inside, "three districts" of green, orange and red, "three things" before, during and after the event, "two-day pre-purification" and "two-director system", and "one zone" management. In emergency situations, we adopt a simplified version of the cluster hospital infection prevention and control system. In emergency situations, a simplified version of the "Cluster" hospital infection prevention and control system can be adopted. This system has the following characteristics: firstly, the system emphasizes the characteristics of "cluster" and the overall management of key measures to avoid any shortcomings. The second, it emphasizes the transformation of infection control concepts to maximize the safety of medical services through infection control. The third, it emphasizes the optimization of the process. The prevention and control measures should be comprehensive and focused, while also preventing excessive use. The measures emphasize the use of the least resources to achieve the best infection control effect. The fourth, it emphasizes the quality control work of infection control, pays attention to the importance of the process, and advocates the concept of "system slimming, process fattening". Fifthly, it emphasizes that the future development depends on artificial intelligence, in order to improve the quality and efficiency of prevention and control to the greatest extent. Sixth, hospitals need to strengthen continuous training and retraining. We utilize diverse training methods, including artificial intelligence, to ensure that infection control policies and procedures are simple. We have established an evaluation and feedback mechanism to ensure that medical personnel are in an emergency state at all times.