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 explore the distribution of pathogens isolated from the thoracoscopic lobectomy patients with postoperative pulmonary infections and observe the expressions of maternal expression gene 3(MEG3)/microribonucleic acid-223(miR-223)/nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)axis in peripheral blood.METHODS Totally 48 lung cancer patients who underwent thoracoscopic lobec-tomy and had postoperative pulmonary infections in the First Affiliated Hospital of Guangzhou University of Chi-nese Medicine from Jun.2021 to Jun.2024 were assigned as the infection group,meanwhile,31 lung cancer pa-tients who underwent thoracoscopic lobectomy but did not have postoperative infections were chosen as the no in-fection group.The sputum specimens were collected from the infection group,the distribution of isolated patho-gens was analyzed.The clinical data and the expression MEG3,miR-223 and NLRP3 were observed and compared between the two groups.The values of MEG3,miR-223 and NLRP3 in prediction of the postoperative infections were analyzed by receiver operating characteristic(ROC)curves.RESULTS Totally 63 strains of pathogens were i-solated from the 48 thoracoscopic lobectomy patients with postoperative pulmonary infections,33(52.38％)of which were gram-negative bacteria,25(39.68％)were gram-positive bacteria,and 5(7.94％)were fungi.There were significant differences in age,diabetes mellitus,chronic obstructive pulmonary disease(COPD),operation duration,and expression levels of MEG3,miR-223 and NLRP3 between the infection group and the no infection group(P＜0.05).ROC curve analysis showed that the areas under the curves of MEG3,miR-223 and NLRP3 and the joint detection of the three indexes were 0.861,0.760,0.912 and 0.968,respectively,in prediction of the post-operative pulmonary infections,and the predictive efficiency of the joint detection was highest(P＜0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the thoracoscopic lo-bectomy patients with postoperative pulmonary infections,the occurrence and progression of the infections may be closely associated with the activation of MEG3/miR-223/NLRP3 axis.The joint detection of the three indexes can effectively predict the postoperative pulmonary infections in the thoracoscopic lobectomy patients.

OBJECTIVE To explore the distribution of pathogens isolated from the thoracoscopic lobectomy patients with postoperative pulmonary infections and observe the expressions of maternal expression gene 3(MEG3)/microribonucleic acid-223(miR-223)/nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)axis in peripheral blood.METHODS Totally 48 lung cancer patients who underwent thoracoscopic lobec-tomy and had postoperative pulmonary infections in the First Affiliated Hospital of Guangzhou University of Chi-nese Medicine from Jun.2021 to Jun.2024 were assigned as the infection group,meanwhile,31 lung cancer pa-tients who underwent thoracoscopic lobectomy but did not have postoperative infections were chosen as the no in-fection group.The sputum specimens were collected from the infection group,the distribution of isolated patho-gens was analyzed.The clinical data and the expression MEG3,miR-223 and NLRP3 were observed and compared between the two groups.The values of MEG3,miR-223 and NLRP3 in prediction of the postoperative infections were analyzed by receiver operating characteristic(ROC)curves.RESULTS Totally 63 strains of pathogens were i-solated from the 48 thoracoscopic lobectomy patients with postoperative pulmonary infections,33(52.38％)of which were gram-negative bacteria,25(39.68％)were gram-positive bacteria,and 5(7.94％)were fungi.There were significant differences in age,diabetes mellitus,chronic obstructive pulmonary disease(COPD),operation duration,and expression levels of MEG3,miR-223 and NLRP3 between the infection group and the no infection group(P＜0.05).ROC curve analysis showed that the areas under the curves of MEG3,miR-223 and NLRP3 and the joint detection of the three indexes were 0.861,0.760,0.912 and 0.968,respectively,in prediction of the post-operative pulmonary infections,and the predictive efficiency of the joint detection was highest(P＜0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the thoracoscopic lo-bectomy patients with postoperative pulmonary infections,the occurrence and progression of the infections may be closely associated with the activation of MEG3/miR-223/NLRP3 axis.The joint detection of the three indexes can effectively predict the postoperative pulmonary infections in the thoracoscopic lobectomy patients.

This study was designed to investigate the effect of hypoxia on preeclampsia(PE)by modulating the Src/Siglec-6/SHP2 signaling pathway in the cytoplasm of trophoblast cells.Mouse model of PE was established in normal control and Siglec-6 knockdown mice by L-NAME administration,with aims of studying the changes in vascular diameter of spiral arteries in vivo and examining the expression levels of Siglec-6,p-Src,p-Shp2 and p-ERK1/2 proteins in mouse uterine vascular tissues.While,the effect of Src/Siglec-6/SHP2 on the invasive proliferation of trophoblast cells was explored by culturing human chorionic trophoblast cells HTR-8/SVneo with hypoxia in vitro.In vivo experimental assays showed that the diameter of spiral arteries was reduced in the Siglec-6 knockdown group of mice,and the expression levels of Siglec-6,p-Src,p-SHP2 and p-ERK1/2 proteins were significantly reduced.In vitro hypoxic HTR-8/SVneo cell model results revealed that Siglec-6 overexpression could promote trophoblast cell invasion and proliferation by regulating p-Src,p-SHP2,p-ERK1/2,MMP2,P53 and P21.While,suppression of Src and SHP2 eliminated Siglec-6 overexpression-mediated Siglec-6,p-Src,p-SHP2 and p-ERK1/2 expression,and inhibited the ability of Siglec-6 overexpression to mediate trophoblast invasion and proliferation.Taken together,Siglec-6 plays an important role in preeclampsia,and can alleviate preeclampsia by promoting trophoblast invasion and proliferation through the Src/SHP2 signalling pathway.

Objective:To assess the clinical effectiveness and safety of Omalizumab for treating pediatric allergic asthma in real world in China.Methods:The clinical data of children aged 6 to 11 years with allergic asthma who received Omalizumab treatment in 17 hospitals in China between July 6, 2018 and September 30, 2020 were retrospectively analyzed.Such information as the demographic characteristics, allergic history, family history, total immunoglobulin E (IgE) levels, specific IgE levels, skin prick test, exhaled nitric oxide (FeNO) levels, eosinophil (EOS) counts, and comorbidities at baseline were collected.Descriptive analysis of the Omalizumab treatment mode was made, and the difference in the first dose, injection frequency and course of treatment between the Omalizumab treatment mode and the mode recommended in the instruction was investigated.Global Evaluation of Treatment Effectiveness (GETE) analysis was made after Omalizumab treatment.The moderate-to-severe asthma exacerbation rate, inhaled corticosteroid (ICS) dose, lung functions were compared before and after Omalizumab treatment.Changes in the Childhood Asthma Control Test (C-ACT) and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) results from baseline to 4, 8, 12, 16, 24, and 52 weeks after Omalizumab treatment were studied.The commodity improvement was assessed.The adverse event (AE) and serious adverse event (SAE) were analyzed for the evaluation of Omalizumab treatment safety.The difference in the annual rate of moderate-to-severe asthma exacerbation and ICS reduction was investigated by using t test.The significance level was set to 0.05.Other parameters were all subject to descriptive analysis.A total of 200 allergic asthma patients were enrolled, including 75.5% ( n=151) males and 24.5% ( n=49) females.The patients aged (8.20±1.81) years. Results:The median total IgE level of the 200 patients was 513.5 (24.4-11 600.0) IU/mL.Their median treatment time with Omalizumab was 112 (1-666) days.Their first dose of Omalizumab was 300 (150-600) mg.Of the 200 cases, 114 cases (57.0%) followed the first Omalizumab dosage recommended in the instruction.After 4-6 months of Omalizumab treatment, 88.5% of the patients enrolled ( n=117) responded to Omalizumab.After 4 weeks of treatment with Omalizumab, asthma was well-controlled, with an increased C-ACT score [from (22.70±3.70) points to (18.90±3.74) points at baseline]. Four-six months after Omalizumab administration, the annual rate of moderate-to-severe asthma exacerbation had a reduction of (2.00±5.68) per patient year( t=4.702 5, P<0.001), the median ICS daily dose was lowered [0 (0-240) μg vs. 160 (50-4 000) μg at baseline] ( P<0.001), the PAQLQ score was improved [(154.90±8.57) points vs. (122.80±27.15) points at baseline], and the forced expiratory volume in one second % predicted (FEV 1%pred) was increased [(92.80±10.50)% vs. (89.70±18.17)% at baseline]. In patients with available evaluations for comorbidities, including allergic rhinitis, atopic dermatitis or eczema, urticaria, allergic conjunctivitis and sinusitis, 92.8%-100.0% showed improved symptoms.A total of 124 AE were reported in 58 (29.0%) of the 200 patients, and the annual incidence was 0(0-15.1) per patient year.In 53 patients who suffered AE, 44 patients (83.0%) and 9 patients (17.0%) reported mild and moderate AE, respectively.No severe AE were observed in patients.The annual incidence of SAE was 0(0-1.9) per patient year.Most common drug-related AE were abdominal pain (2 patients, 1.0%) and fever (2 patients, 1.0%). No patient withdrew Omalizumab due to AE. Conclusions:Omalizumab shows good effectiveness and safety for the treatment of asthma in children.It can reduce the moderate-to-severe asthma exacerbation rate, reduce the ICS dose, improve asthma control levels, and improve lung functions and quality of life of patients.

Objective In the patients with calcaneal fractures,the surgical method with intact peroneal tendon sheath was used to treat them,and compared with the traditional surgical method with dynamic retraction of the peroneal tendon,to analyze the influence of the surgical method on the posterior foot movement.Methods A retrospective analysis was made on 60 patients with calcaneal fracture admitted to the Department of Orthopaedics of our hospital from December 2016 to December 2020.The patients were divided into two groups according to the surgical method.The patients in the distraction group received the surgical treatment of traditional dynamic distraction of peroneal tendon(28 cases),and the patients in the preservation group received the surgical treatment of preserving the integrity of peroneal tendon sheath(32 cases).The outcome measures included perioperative indicators,Maryland score of foot function 12 months after surgery,AOFAS score of posterior foot and imaging indicators(Boler Angle and Gissane Angle)12 months after surgery.Results The surgical time(89.34±12.21 minutes)and hospitalization time(5.26±1.47 days)of the retention group were significantly better than those of the traction group[(124.22±11.56)min,(11.59±2.43)d](P＜0.05).At the last follow-up,the AOFAS score(70.56±3.62)and Maryland's excellent and good rate(87.5％)of patients in the retention group were better than those in the traction group(81.37±3.58,71.4％)(P＜0.05).The difference in imaging indicators between the two groups was relatively small(P＞0.05).Conclusion The surgical method of keeping the peroneal tendon sheath intact in the treatment of patients with calcaneal fracture has definite clinical effects,and can also effectively reduce the adverse effects of surgical trauma on posterior foot activity.

Objective: To explore the direct⁃on⁃target micro⁃droplet growth assay (DOT⁃MGA) for rapid detection of the susceptibility of tigecycline and polymyxin. Methods: A total of 67 strains of Klebsiella pneumoniae were collected for DOT⁃MGA. 6 μl droplets with or without tigecycline or polymyxin (The final drug concentration is 2 μg/ml) were added in triplicate into the wells of the MALDI plate with four incubation time points (3 h ,4 h ,6 h , and 8 h) . The results were classified as susceptible (score < 1. 7) and non⁃susceptible (score≥1 . 7) according to the Bruker Biotype software Results: After incubation for 4 h , the growth efficiency, specificity and positive predictive value of tigecycline and polymyxin were both 100. 00% . The classification consistency rate was 98. 15% and 96. 15% , the sensitivity was 96. 30% and 92. 31% , and the negative predictive value was 96. 45% and 92. 86% , respectively. Conclusion DOT⁃MGA can provide rapid and reliable drug susceptibility diagnosis of tigecycline and polymyxin ,which is of great significance for the clinical anti⁃infective treatment.

Objective:To evaluate the regulatory role and potential mechanism of Urease B(UreB) on macrophages.Methods:Bone marrow-derived macrophages (M0) were stimulated by recombinant UreB protein and then flowcytometry and ELISA were used to detect the apoptosis, polarization and antigen presentation-related biomarkers expression. CD4 + T cell co-culture assay, CFSE stain and flowcytometry were used to evaluate the impacts of UreB on antigen presentation capacity of macrophages. Truncated UreB protein, NanoBiT assay and co-immunoprecipitation were used to identify the binding sites of UreB to TLR2. Results:UreB promoted apoptosis and skewed macrophages from M1 to M2 in the presence of M1-inducer LPS. Moreover, UreB inhibited the expression of antigen presentation biomarkers, MHCⅡ and CD86 on macrophages, and further inhibited the proliferation and IFN-γ expression of CD4 + T cells. Molecular analyses revealed that the binding between seven carboxy-terminal amino acid residues of UreB and TLR2 were required for the UreB-mediated inhibitory effects. Conclusions:The findings in this study demonstrate that UreB mainly depends on the binding between seven carboxy-terminal amino acid residues and TLR2 to perform immune-suppressive activities, and which may provide valuable information for the design and optimization of UreB-based vaccines against Helicobacter pylori infection.

Objective:To investigate the mechanism of PE_PGRS60 protein in the pathogenesis of Mycobacterium tuberculosis infection. Methods:The cloned and purified PE_PGRS60 protein from Mycobacterium tuberculosis was used to stimulate RAW264.7 cells. The expression of cyclooxygenase 2(COX2) mRNA and protein was detected by qRT-PCR and Western blot, respectively. The signal pathways that may regulate the expression of COX2 were screened, and the expression of inflammatory cytokines induced by PE_PGRS60 was detected by ELISA. The level of cell death was measured by lactate dehydrogenase(LDH) release test and flow cytometry PI staining. Western blot was used to detect the expression of COX2 in Peripheral blood mononuclear cell(PBMC) from active tuberculosis patients. Results:PE_PGRS60 protein was found to promote the expression of COX2 in RAW264.7 cells and activate the three major members of the mitogen-activated protein kinase(MAPK) family: extracellular regulated protein kinase(ERK), p38 and c-Jun N-terminal kinase(JNK). Interestingly, only JNK-IN-7, the inhibitor of JNK was observed to suppress the up-regulation expression of COX2 induced by PE_PGRS60. This up-regulated expression of COX2 was also found in PBMCs from active tuberculosis patients. The COX2 inhibitor celecoxib can effectively block the expression of the inflammatory factors IL-1β, TNF-α and IL-6 induced by PE_PGRS60 and promote macrophage death.Conclusions:PE_PGRS60 can promote macrophages to release inflammatory factors by activating JNK/COX2 signal axis. Some macrophages still die under the protection of COX2.