ObjectiveTo explore the host immunomodulatory effect and its molecular mechanism of gallic acid （GA） in Bacillus Calmette-Guérin （BCG） infected macrophages， and to provide experimental evidence for host-directed anti-tuberculosis research against Mycobacterium tuberculosis （Mtb）. MethodsThe minimum inhibitory concentration （MIC） of GA against BCG was determined by resazurin colorimetric assay. Bacterial growth-curve test and MTT colorimetric assay were used to evaluate the effects of GA on BCG proliferation and invasion. A BCG-infected RAW264.7 macrophage model was established， including infection control group （Ctrl）， isoniazid （INH） group， and low-， medium- and high-dose GA groups. Flow cytometry combined with colony-plate counting was performed to detect intracellular BCG survival. Cell apoptosis was measured by Annexin V-APC/7-AAD double staining， and qRT-PCR was used to detect the mRNA expression of apoptosis-related genes Caspase-3 and Bcl-2. Macrophage polarization phenotypes were analyzed by flow cytometry. Intracellular reactive oxygen species （ROS） were detected using DHE fluorescent probe. The Griess assay was applied to determine supernatant nitric oxide （NO） concentration. ELISA was used to detect the levels of TNF-α， IFN-γ， IL-6 and IL-10 in cell culture supernatant. ResultsThe MIC of GA against BCG was 1 250 μmol/L. GA inhibited BCG proliferation and invasion in a concentration-dependent manner （P＜0.05）. Safe concentrations of 20， 40 and 80 μmol/L were selected for subsequent cellular experiments. Thirty-six-hour GA pretreatment markedly reduced the intracellular BCG bacterial load （P＜0.05）. GA exerted bidirectional regulation on macrophage apoptosis： it inhibited apoptosis at the early-stage infection and promoted apoptosis at the late-stage infection. GA induced M1-type polarization in early infection and facilitated M2-type polarization in late infection （P＜0.05）. Meanwhile， GA decreased intracellular ROS and NO levels， down-regulated the secretion of pro-inflammatory cytokines and up-regulated the secretion of anti-inflammatory cytokine IL-10 （P＜0.05）. ConclusionGA inhibits BCG proliferation and invasion in vitro. It remodels host immune microenvironment via bidirectional regulation of macrophage apoptosis and polarization as well as anti-oxidative and anti-inflammatory effects， showing potential value for host-directed anti-mycobacterial therapy.

ObjectiveTo explore the host immunomodulatory effect and its molecular mechanism of gallic acid （GA） in Bacillus Calmette-Guérin （BCG） infected macrophages， and to provide experimental evidence for host-directed anti-tuberculosis research against Mycobacterium tuberculosis （Mtb）. MethodsThe minimum inhibitory concentration （MIC） of GA against BCG was determined by resazurin colorimetric assay. Bacterial growth-curve test and MTT colorimetric assay were used to evaluate the effects of GA on BCG proliferation and invasion. A BCG-infected RAW264.7 macrophage model was established， including infection control group （Ctrl）， isoniazid （INH） group， and low-， medium- and high-dose GA groups. Flow cytometry combined with colony-plate counting was performed to detect intracellular BCG survival. Cell apoptosis was measured by Annexin V-APC/7-AAD double staining， and qRT-PCR was used to detect the mRNA expression of apoptosis-related genes Caspase-3 and Bcl-2. Macrophage polarization phenotypes were analyzed by flow cytometry. Intracellular reactive oxygen species （ROS） were detected using DHE fluorescent probe. The Griess assay was applied to determine supernatant nitric oxide （NO） concentration. ELISA was used to detect the levels of TNF-α， IFN-γ， IL-6 and IL-10 in cell culture supernatant. ResultsThe MIC of GA against BCG was 1 250 μmol/L. GA inhibited BCG proliferation and invasion in a concentration-dependent manner （P＜0.05）. Safe concentrations of 20， 40 and 80 μmol/L were selected for subsequent cellular experiments. Thirty-six-hour GA pretreatment markedly reduced the intracellular BCG bacterial load （P＜0.05）. GA exerted bidirectional regulation on macrophage apoptosis： it inhibited apoptosis at the early-stage infection and promoted apoptosis at the late-stage infection. GA induced M1-type polarization in early infection and facilitated M2-type polarization in late infection （P＜0.05）. Meanwhile， GA decreased intracellular ROS and NO levels， down-regulated the secretion of pro-inflammatory cytokines and up-regulated the secretion of anti-inflammatory cytokine IL-10 （P＜0.05）. ConclusionGA inhibits BCG proliferation and invasion in vitro. It remodels host immune microenvironment via bidirectional regulation of macrophage apoptosis and polarization as well as anti-oxidative and anti-inflammatory effects， showing potential value for host-directed anti-mycobacterial therapy.

Objective:To assess the predictive performance of a nomogram model integrating endoscopic ultrasound（EUS）radiomic features with clinical variables for distinguishing early esophageal squamous cell carcinoma（ESCC）from non-cancerous lesions.Methods:Clinical and imaging data from 454 patients who underwent EUS for suspected esophageal malignancies were retrospectively collected in the First Affiliated Hospital of Nanjing Medical University（training cohort， n = 323）and Dongyang People's Hospital（external validation cohort， n = 131）from January 2020 to November 2023. Independent clinical predictors of early ESCC were identified using univariable and multivariable Logistic regression analyses to establish a clinical model. Pearson correlation and Least Absolute Shrinkage and Selection Operator（LASSO）algorithms were used to construct a radiomics model. A combined model integrating radiomics scores and clinical predictors was developed and visualized as a nomogram. The predictive performance of each model was assessed using the area under the ROC curve（AUC），and calibration curves were used to evaluate the model's fitting capability. Results:The training set and validation set indicated that there were statistically significant differences in age，smoking history and lesion location between the early ESCC group and the non-cancerous lesion change group（all P < 0.05）. According to univariate and multivariate Logistic regression analysis，age（ OR = 1.039，95% CI = 1.003–1.077， P = 0.036）and smoking（ OR = 2.358，95% CI = 1.270 - 4.376， P = 0.007）were identified as independent predictors and used to develop the clinical model，with AUCs of 0.608 and 0.694 in the training and validation cohorts，respectively. Fourteen optimal radiomic features were selected to construct the radiomics model，with AUCs of 0.881 and 0.807 in the training and validation cohorts，respectively. The combined nomogram model demonstrated superior predictive performance with AUCs of 0.893 and 0.830，sensitivities of 82.5% and 79.1%，and specificities of 82.2% and 81.3% in the training and validation cohorts，respectively. Conclusions:The EUS-based nomogram model demonstrates optimal predictive performance and can serve as a non-invasive tool to assist endoscopists in distinguishing early ESCC from non-cancerous lesions.

Objective·To Investigate the effects of salidroside(SAL)on the immune response of macrophages infected with BCG.Methods·RAW264.7 mouse macrophages were infected with BCG,and the experiments were divided into blank control(BCG),salidroside(SAL+BCG),isoniazid(INH+BCG),and salidroside+isoniazid(SAL+INH+BCG)groups.The effects of SAL and INH on the proliferation of RAW264.7 cells were detected by MTT colorimetric assay,and the experimental concentrations of SAL and INH were screened.After the establishment of the BCG-infected macrophage model,intracellular bacterial survival was detected by bacterial plate count and flow cytometry following salidroside pretreatment.The levels of tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),interleukin-6(IL-6),and interleukin-10(IL-10)in the culture supernatants were measured by enzyme-linked immunosorbent assay,and apoptosis levels were assessed by flow cytometry.Results·SAL at a concentration of 800 μmol/L and INH at 10 μmol/L were selected for subsequent experiments.Compared with the BCG group,SAL pretreatment for 36 h had the best effect,and the growth of BCG in macrophages in the administered group was inhibited.The inhibitory effect of the combined application of SAL and INH was obvious and statistically significant.Compared with the BCG group,SAL alone led to decreased secretion of TNF-α,IFN-γ,IL-6,and IL-10,although the differences were not statistically significant.However,the combination of SAL and INH caused a significant decrease in the levels of TNF-α,IL-6 and IL-10 in the supernatants of the cells(all P<0.05).Compared with the BCG group,in the early stage of the infection,SAL and INH were able to significantly reduce the apoptotic levels of BCG-infected RAW264.7 cells(P=0.008,P=0.032),and the combined application of SAL and INH significantly enhanced the apoptosis levels of BCG-infected RAW264.7 cells in the late stage of infection(P=0.001).Conclusion·In BCG-infected macrophages,SAL can exhibit antimycobacterial effects on the host by enhancing macrophage immune function,suppressing intracellular bacterial survival,and concurrently mitigating the inflammatory response elicited by BCG infection.

Objective·To Investigate the effects of salidroside(SAL)on the immune response of macrophages infected with BCG.Methods·RAW264.7 mouse macrophages were infected with BCG,and the experiments were divided into blank control(BCG),salidroside(SAL+BCG),isoniazid(INH+BCG),and salidroside+isoniazid(SAL+INH+BCG)groups.The effects of SAL and INH on the proliferation of RAW264.7 cells were detected by MTT colorimetric assay,and the experimental concentrations of SAL and INH were screened.After the establishment of the BCG-infected macrophage model,intracellular bacterial survival was detected by bacterial plate count and flow cytometry following salidroside pretreatment.The levels of tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),interleukin-6(IL-6),and interleukin-10(IL-10)in the culture supernatants were measured by enzyme-linked immunosorbent assay,and apoptosis levels were assessed by flow cytometry.Results·SAL at a concentration of 800 μmol/L and INH at 10 μmol/L were selected for subsequent experiments.Compared with the BCG group,SAL pretreatment for 36 h had the best effect,and the growth of BCG in macrophages in the administered group was inhibited.The inhibitory effect of the combined application of SAL and INH was obvious and statistically significant.Compared with the BCG group,SAL alone led to decreased secretion of TNF-α,IFN-γ,IL-6,and IL-10,although the differences were not statistically significant.However,the combination of SAL and INH caused a significant decrease in the levels of TNF-α,IL-6 and IL-10 in the supernatants of the cells(all P<0.05).Compared with the BCG group,in the early stage of the infection,SAL and INH were able to significantly reduce the apoptotic levels of BCG-infected RAW264.7 cells(P=0.008,P=0.032),and the combined application of SAL and INH significantly enhanced the apoptosis levels of BCG-infected RAW264.7 cells in the late stage of infection(P=0.001).Conclusion·In BCG-infected macrophages,SAL can exhibit antimycobacterial effects on the host by enhancing macrophage immune function,suppressing intracellular bacterial survival,and concurrently mitigating the inflammatory response elicited by BCG infection.

Objective:To assess the predictive performance of a nomogram model integrating endoscopic ultrasound（EUS）radiomic features with clinical variables for distinguishing early esophageal squamous cell carcinoma（ESCC）from non-cancerous lesions.Methods:Clinical and imaging data from 454 patients who underwent EUS for suspected esophageal malignancies were retrospectively collected in the First Affiliated Hospital of Nanjing Medical University（training cohort， n = 323）and Dongyang People's Hospital（external validation cohort， n = 131）from January 2020 to November 2023. Independent clinical predictors of early ESCC were identified using univariable and multivariable Logistic regression analyses to establish a clinical model. Pearson correlation and Least Absolute Shrinkage and Selection Operator（LASSO）algorithms were used to construct a radiomics model. A combined model integrating radiomics scores and clinical predictors was developed and visualized as a nomogram. The predictive performance of each model was assessed using the area under the ROC curve（AUC），and calibration curves were used to evaluate the model's fitting capability. Results:The training set and validation set indicated that there were statistically significant differences in age，smoking history and lesion location between the early ESCC group and the non-cancerous lesion change group（all P < 0.05）. According to univariate and multivariate Logistic regression analysis，age（ OR = 1.039，95% CI = 1.003–1.077， P = 0.036）and smoking（ OR = 2.358，95% CI = 1.270 - 4.376， P = 0.007）were identified as independent predictors and used to develop the clinical model，with AUCs of 0.608 and 0.694 in the training and validation cohorts，respectively. Fourteen optimal radiomic features were selected to construct the radiomics model，with AUCs of 0.881 and 0.807 in the training and validation cohorts，respectively. The combined nomogram model demonstrated superior predictive performance with AUCs of 0.893 and 0.830，sensitivities of 82.5% and 79.1%，and specificities of 82.2% and 81.3% in the training and validation cohorts，respectively. Conclusions:The EUS-based nomogram model demonstrates optimal predictive performance and can serve as a non-invasive tool to assist endoscopists in distinguishing early ESCC from non-cancerous lesions.

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 standardize the strategies for prevention and control of Chikungunya(CHIK)in healthcare in-stitutions so as to reduce the risk of transmission in the institutions.METHODS A working group comprising the ex-perts in hospital infection control,infectious diseases,and microbiology systematically reviewed domestic and international evidence and current guidelines,integrated China's vector ecology and healthcare realities,conducted two rounds of Delphi to achieve expert consensus,and graded the evidence and recommendation strength using the Oxford Centre for Evidence Based Medicine system.RESULTS The consensus issues 18 actionable recommendations on triage,patient mosquito-proof isolation,integrated vector control,protection of susceptible populations,environmental cleaning and disinfection,specimen management,medical textile handling,and outbreak emergency response,with each statement assigned an evi-dence level and recommendation strength.CONCLUSION This consensus is for the first time in China to provide evidence-graded strategies for control of CHIK in healthcare institutions,offering work flow-oriented,implementable guidance for clinicians,laboratorians,and infection-control personnel under different risk scenarios and enhancing the comprehensive coping capacity of the healthcare institutions.

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 standardize the strategies for prevention and control of Chikungunya(CHIK)in healthcare in-stitutions so as to reduce the risk of transmission in the institutions.METHODS A working group comprising the ex-perts in hospital infection control,infectious diseases,and microbiology systematically reviewed domestic and international evidence and current guidelines,integrated China's vector ecology and healthcare realities,conducted two rounds of Delphi to achieve expert consensus,and graded the evidence and recommendation strength using the Oxford Centre for Evidence Based Medicine system.RESULTS The consensus issues 18 actionable recommendations on triage,patient mosquito-proof isolation,integrated vector control,protection of susceptible populations,environmental cleaning and disinfection,specimen management,medical textile handling,and outbreak emergency response,with each statement assigned an evi-dence level and recommendation strength.CONCLUSION This consensus is for the first time in China to provide evidence-graded strategies for control of CHIK in healthcare institutions,offering work flow-oriented,implementable guidance for clinicians,laboratorians,and infection-control personnel under different risk scenarios and enhancing the comprehensive coping capacity of the healthcare institutions.