Objective:To analyze the chemical components of the Tibetan medicinal material Potentilla anserina L. based on UPLC-Q-EXACTIVE-MS/MS; To establish its fingerprint and content determination method combined with UPLC; To provide the basis for its quality evaluation. Methods:Intelligent UPLC-Q-Exactive-MS/MS combined with literature and PubChem database was used to identify chemical components of Potentilla anserina L. HPLC method was used to establish fingerprints of 12 batches of Potentilla anserina L. Chemical pattern analysis was performed to identify markers of difference. The content of quality markers was quantitatively analyzed. Results:14 chemical components were identified from Potentilla anserina L, including 10 flavonoids, 3 oils and 1 proanthocyanidins; 15 common peaks and 7 chemical components were identified from the fingerprints of Potentilla anserina L.; chemical patterns identified 8 difference markers; the content determination results showed that the contents of catechin, Kaji-ichigoside F1, rosamultin, tormentic acid , pomolic acid and ursolic acid in different batches were among 0.028-0.080 mg/g, 0.144-0.361 mg/g, 0.323-0.630 mg/g, 0.233-0.645 mg/g, 0.214-0.384 mg/g, 0.115-0.203 mg/g, respectively. Conclusion:This study can provide a reference for the study of chemical constituents and pharmacodynamic substances of Potentilla anserina L., and provide a scientific basis for the objective evaluation of the quality of Potentilla anserina L. and the improvement of its quality control.

OBJECTIVE To investigate and control a suspected outbreak of hospital-associated Elizabethkingia a-nopheles infection in respiratory intensive care unit(RICU),and provide scientific basis for effective prevention and control of hospital-associated E.anophelis infection.METHODS The tracking source analysis was performed for 9 identified cases who were detected with E.anophelis through epidemiological survey,environmental hy-giene monitoring and endoscopic cavity visualization system,the surroundings that they contacted and the instru-ments they were treated with were investigated.The targeted prevention and control measures were implemented.RESULTS A total of 55 samples were collected from the surrounding environment and shared instru-ments of 9 patients detected with E.anophelis.Totally 6 samples were detected positive for the environmental ob-ject surfaces of 3 patients,and 15 positive samples were identified as the same source by homology analysis.Two faulty bronchoscopes were found through the visualization system of lumen instruments.CONCLUSIONS There are multiple pathways of cross-contamination of bronchoscope and person-to person transmission of E.anophelis in RICU.Strengthening the management of cleaning and disinfection of bronchoscope,increasing the frequency of cleaning and disinfection of RICU environmental surfaces and improving the compliance of hand hy-giene of medical staff are important measures to control the outbreak of hospital-associated infection.

Objective To investigate the molecular typing,virulence,and drug resistance characteristics of Staphylococcus aureus(SA)in bone and joint infections,providing basis for anti-infection treatment.Methods The SA strains isolated from inpatients with bone and joint infections in Beijing Jishuitan Hospital,Capital Medical University from January 2014 to December 2021 were collected.Multi-locus sequence typing(MLST)and Staphylococcal A protein(Spa)typing for all the strains and Staphylococcal cassette chromo-some mec(SCCmec)typing of methicillin-resistant Staphylococcus aureus(MRSA)were performed based on whole genome sequencing.The virulence genes and drug resistance genes of the strains were identified by online database.The antimicrobial susceptibility tests were carried by automatic microbiological assay system.Results MRSA accounted for 30.0％of the 100 isolated strains of SA.A total of 22 ST types and 39 Spa types were identified in the 100 strains of S.aureus,among which ST59(16.0％)and ST239(14.0％)were the dominant ST types,and t437(13.0％)and t030(10.0％)were the dominant Spa types.ST239-SCCmecⅢ-t030/t037 clone(46.7％)was the main epidemic clone in MRSA isolates.The biofilm gene(icaA,icaB,icaC,icaD,icaR),hemolysin gene(hlb,hld,hlgA,hlgB,hlgC),adhesion gene(clfA,clfB,fnbA,fnbB,ebp),and immune escape gene(adsA,sbi,scn)were widespread in all SA strains,with detection rates ranging from 89.0％to 100.0％.The detection rates of enterotoxin genes seb(43.3％),selk(93.8％)and selq(83.3％)in MRSA were significantly higher than those in methicillin-sensitive Staphylococcus aureus(MSSA)(all P＜0.05).In terms of drug-resistance characteristics,the detection rate of the resistance gene blaZ(87.0％)was the highest among all the S.aureus strains.In the isolated MRSA strains,the detection rate of resistance genes for erm(A),tet(M),aph(3')-Ⅲ,ant(6)-Ⅰa,ant(9)-Ⅰa,and aac(6')-aph(2")ranged from 43.3％to 50.0％,which were significantly higher than those in MSSA(all P＜0.05).The results of the drug-sensitivity test showed that the resistant rates of S.aureus strains to penicillin,erythromycin,and clindamycin were relatively high(89.0％,67.0％,and 51.0％,respectively).The resistant rates of MRSA to the antimicrobial agents commonly used in clinical practice were significantly higher than those of MSSA(all P＜0.05).Conclusion The molecular epidemiological char-acteristics of SA strains isolated from bone and joint infections were diversified in our hospital.ST239-SCCmecⅢ-t030/t037 was the most common epidemic clone among the strains.There were significant differences in the resistance genes and drug resistance rates be-tween MRSA and MSSA strains,for which clinical attention should be paid.

OBJECTIVE To investigate and control a suspected outbreak of hospital-associated Elizabethkingia a-nopheles infection in respiratory intensive care unit(RICU),and provide scientific basis for effective prevention and control of hospital-associated E.anophelis infection.METHODS The tracking source analysis was performed for 9 identified cases who were detected with E.anophelis through epidemiological survey,environmental hy-giene monitoring and endoscopic cavity visualization system,the surroundings that they contacted and the instru-ments they were treated with were investigated.The targeted prevention and control measures were implemented.RESULTS A total of 55 samples were collected from the surrounding environment and shared instru-ments of 9 patients detected with E.anophelis.Totally 6 samples were detected positive for the environmental ob-ject surfaces of 3 patients,and 15 positive samples were identified as the same source by homology analysis.Two faulty bronchoscopes were found through the visualization system of lumen instruments.CONCLUSIONS There are multiple pathways of cross-contamination of bronchoscope and person-to person transmission of E.anophelis in RICU.Strengthening the management of cleaning and disinfection of bronchoscope,increasing the frequency of cleaning and disinfection of RICU environmental surfaces and improving the compliance of hand hy-giene of medical staff are important measures to control the outbreak of hospital-associated infection.

Objective To investigate the molecular typing,virulence,and drug resistance characteristics of Staphylococcus aureus(SA)in bone and joint infections,providing basis for anti-infection treatment.Methods The SA strains isolated from inpatients with bone and joint infections in Beijing Jishuitan Hospital,Capital Medical University from January 2014 to December 2021 were collected.Multi-locus sequence typing(MLST)and Staphylococcal A protein(Spa)typing for all the strains and Staphylococcal cassette chromo-some mec(SCCmec)typing of methicillin-resistant Staphylococcus aureus(MRSA)were performed based on whole genome sequencing.The virulence genes and drug resistance genes of the strains were identified by online database.The antimicrobial susceptibility tests were carried by automatic microbiological assay system.Results MRSA accounted for 30.0％of the 100 isolated strains of SA.A total of 22 ST types and 39 Spa types were identified in the 100 strains of S.aureus,among which ST59(16.0％)and ST239(14.0％)were the dominant ST types,and t437(13.0％)and t030(10.0％)were the dominant Spa types.ST239-SCCmecⅢ-t030/t037 clone(46.7％)was the main epidemic clone in MRSA isolates.The biofilm gene(icaA,icaB,icaC,icaD,icaR),hemolysin gene(hlb,hld,hlgA,hlgB,hlgC),adhesion gene(clfA,clfB,fnbA,fnbB,ebp),and immune escape gene(adsA,sbi,scn)were widespread in all SA strains,with detection rates ranging from 89.0％to 100.0％.The detection rates of enterotoxin genes seb(43.3％),selk(93.8％)and selq(83.3％)in MRSA were significantly higher than those in methicillin-sensitive Staphylococcus aureus(MSSA)(all P＜0.05).In terms of drug-resistance characteristics,the detection rate of the resistance gene blaZ(87.0％)was the highest among all the S.aureus strains.In the isolated MRSA strains,the detection rate of resistance genes for erm(A),tet(M),aph(3')-Ⅲ,ant(6)-Ⅰa,ant(9)-Ⅰa,and aac(6')-aph(2")ranged from 43.3％to 50.0％,which were significantly higher than those in MSSA(all P＜0.05).The results of the drug-sensitivity test showed that the resistant rates of S.aureus strains to penicillin,erythromycin,and clindamycin were relatively high(89.0％,67.0％,and 51.0％,respectively).The resistant rates of MRSA to the antimicrobial agents commonly used in clinical practice were significantly higher than those of MSSA(all P＜0.05).Conclusion The molecular epidemiological char-acteristics of SA strains isolated from bone and joint infections were diversified in our hospital.ST239-SCCmecⅢ-t030/t037 was the most common epidemic clone among the strains.There were significant differences in the resistance genes and drug resistance rates be-tween MRSA and MSSA strains,for which clinical attention should be paid.

Objective To evaluate the testing capabilities of laboratories,analyze existing issues,and improve testing quality,through carrying out the external quality assessment(EQA)of clinical laboratories for human papillomavirus(HPV)type 6 and 11 nucleic acid detection.Methods EQA plan was carried out twice a year.Each panel contains 4 positive samples,including one strong positive sample and one weak positive sample of HPV6 and HPV11,made from cervical secretions from patients with clinical manifestations of condyloma acuminata(CA)and positive for HPV6 or HPV11(from Shanghai First Maternity and Infant Hospital).One negative sample was cultured from the C-33A cell line(from Chinese Academy of Sciences).Samples were sent to participating laboratories by cold chain,and laboratories were required to detect test samples and upload their results within the specified time.Shanghai Center for Clinical Laboratory(SCCL)calculated the scores of each laboratory based on the return results.Results A total of 163 sample panels were sent out in the 6 rounds of EQA plan and 140 valid reports were received.The laboratory qualification rate was 96.43%(135/140)and the sample compliance rate was 97.86%(685/700).There were 13 false negative results and 2 false positive results,with weakly positive samples accounting for 76.92%(10/13)of the false negative results.Conclusion The detection accuracy of HPV6/11 nucleic acid in each laboratory was relatively high,and the detection ability of weak positive samples in individual laboratories may need to be improved.The laboratory could discover problems and improve its quality management by participating in EQA.

This article introduces a high-magnification electronic endoscope system that utilizes a continuous zoom optical design,enabling high-magnification imaging at the cellular level.By selecting an appropriate initial retrofocus structure,the optimized modulation transfer function(MTF)curve of the zoom objective lens approaches the diffraction limit.Additionally,the tip and operation parts of the system incorporate modular gas-tight sealing and multiple layers of protective structure.The design employs efficient sealing materials and precise packaging techniques to ensure the system's sealing performance.The experimental results indicate that,under conventional imaging,the resolution is equivalent to 39.37 μm in object space,and the field of view angle is larger than 140 degrees.At magnified imaging,the resolution is equivalent to 2.78 μm in object space,and the observed actual field of view is greater than 800 μm×700 μm.When used with a 26-inch display monitor,the high-magnification electronic endoscope can achieve 500×optical magnification,allowing for the observation of features at the cellular level.Currently,this product has successfully achieved mass production and has undergone multiple animal trials,demonstrating its wide range of potential applications and significant clinical value.

Enhanced recovery after surgery has reduced the number and duration of medical catheter placements through perioperative optimization measures. However, in clinical practice, catheters are still inevitably heavily used, and the risk of catheter-related infections persists. Preventing bacterial adhesion and biofilm formation on catheter surfaces is crucial. Medical antibacterial-coated catheters introduce substances that prevent fouling and adhesion, inhibit or kill bacteria on the surface, forming an antibacterial functional surface, providing a new strategy to address catheter-related infections. This article summarizes the current research status of medical antibacterial-coated catheters, introduces the antibacterial strategies and principles of the coatings, describes their actual effects in clinical applications, and analyzes future research directions. These studies help reduce catheter-related infections, promote innovation in clinical nursing technology, and improve the quality and efficiency of nursing care.

Enhanced recovery after surgery has reduced the number and duration of medical catheter placements through perioperative optimization measures. However, in clinical practice, catheters are still inevitably heavily used, and the risk of catheter-related infections persists. Preventing bacterial adhesion and biofilm formation on catheter surfaces is crucial. Medical antibacterial-coated catheters introduce substances that prevent fouling and adhesion, inhibit or kill bacteria on the surface, forming an antibacterial functional surface, providing a new strategy to address catheter-related infections. This article summarizes the current research status of medical antibacterial-coated catheters, introduces the antibacterial strategies and principles of the coatings, describes their actual effects in clinical applications, and analyzes future research directions. These studies help reduce catheter-related infections, promote innovation in clinical nursing technology, and improve the quality and efficiency of nursing care.

Objective:To explore the status quo and influencing factors of caregivers' perception of nurses' empowerment behavior in children with type 1 diabetes mellitus (T1DM) , and to provide scientific basis for focusing on and efficiently empowering caregivers of children with T1DM.Methods:This study was a cross-sectional survey. A total of 360 children with T1DM who were admitted to 2 tertiary hospitals in Zhejiang Province from January 2019 to May 2020 were selected by the convenient sampling method. General information questionnaire, Patient Perceptions of Patient-Empowering Nurse Behaviors Scale (PPPNBS) and General Self-Efficacy Scale (GSES) were used to investigate and analyze the influencing factors. A total of 360 questionnaires were issued and 347 valid questionnaires were recovered, with an effective response rate of 96.4%.Results:The PPPNBS score of caregivers of 347 children with T1DM was (185.85±50.05) . Multiple linear regression analysis showed that the course of the disease, the age of the caregiver, the education background of caregivers and self-efficacy sense were influencing factors of perception of empowerment behavior of caregivers of children with T1DM ( P<0.05) . Conclusions:The perception of caregivers of T1DM children with nurses' empowerment behavior is at a moderate level. The course of the disease, age of caregivers, the education background of caregivers and self-efficacy are the influencing factors in perception of caregivers' empowerment behaviors of T1DM children. Medical staff should formulate targeted intervention measures based on the influencing factors of the perception of empowerment behaviors to improve the perception of nurses' empowerment behaviors by caregivers of patients.