Objective To understand the current status of the job competency of full-time healthcare-associated in-fection(HAI)management professionals in all levels and types of medical institutions across China,and provide in-formation and basis for professional training,competency improvement,and career planning.Methods The strati-fied sampling method was adopted to select HAI management professionals from medical institutions in 31 provin-cial-level administrative regions across the country as the research subjects.The designed content of questionnaire involved four parts,including the surveyed personnel's basic information,daily job competency assessment,satis-faction level towards the job,as well as opinions and suggestions on the management of full-time HAI management professionals.The assessment on daily job competency was divided into 13 dimensions,ranging from very incompe-tent to very competent in 5 levels.The scores of HAI management professionals with different professional back-grounds were compared and analyzed.Results A total of 8 709 valid questionnaires were collected,with 3 475 and 3 697 surveyed personnel from tertiary and secondary medical institutions,respectively,and 1 537 from primary or unclassified medical institutions.The overall average score for the competency assessment of full-time HAI manage-ment professionals was(4.17±0.80)points.The scores of professionals with different professional backgrounds,from high to low,were as follows:nursing([4.12±0.81]points),clinical medicine([4.07±0.86]points),pre-ventive medicine([3.93±0.92]points),laboratory medicine([3.88±0.93]points),pharmacy([3.86±0.94]points),and health management([3.85±0.95]points).For the core competency of HAI management professio-nals,such as monitoring and analyzing HAI cases,identifying and investigating HAI outbreaks,the assessment scores for professionals with medical backgrounds were the highest(both P＜0.05).For the basic work of HAI prevention and control,such as checking and guiding the implementation of rules and regulations,guiding occupa-tional protection,management and communication,and implementing HAI management training,professionals with a nursing background had the highest assessment scores(all P＜0.05).Full-time HAI management professionals were relatively satisfied with their training,while those with a background in preventive medicine had lower satisfac-tion with their training,career development,and job benefits(all P＜0.05).Conclusion There are significant differences in the competency of HAI management professionals with different professional backgrounds.It is nece-ssary to optimize division of labor and leverage the strengths,providing ideas and models for promoting the construction of a specialized and professional HAI management team.

Objective To understand the current status of the job competency of full-time healthcare-associated in-fection(HAI)management professionals in all levels and types of medical institutions across China,and provide in-formation and basis for professional training,competency improvement,and career planning.Methods The strati-fied sampling method was adopted to select HAI management professionals from medical institutions in 31 provin-cial-level administrative regions across the country as the research subjects.The designed content of questionnaire involved four parts,including the surveyed personnel's basic information,daily job competency assessment,satis-faction level towards the job,as well as opinions and suggestions on the management of full-time HAI management professionals.The assessment on daily job competency was divided into 13 dimensions,ranging from very incompe-tent to very competent in 5 levels.The scores of HAI management professionals with different professional back-grounds were compared and analyzed.Results A total of 8 709 valid questionnaires were collected,with 3 475 and 3 697 surveyed personnel from tertiary and secondary medical institutions,respectively,and 1 537 from primary or unclassified medical institutions.The overall average score for the competency assessment of full-time HAI manage-ment professionals was(4.17±0.80)points.The scores of professionals with different professional backgrounds,from high to low,were as follows:nursing([4.12±0.81]points),clinical medicine([4.07±0.86]points),pre-ventive medicine([3.93±0.92]points),laboratory medicine([3.88±0.93]points),pharmacy([3.86±0.94]points),and health management([3.85±0.95]points).For the core competency of HAI management professio-nals,such as monitoring and analyzing HAI cases,identifying and investigating HAI outbreaks,the assessment scores for professionals with medical backgrounds were the highest(both P＜0.05).For the basic work of HAI prevention and control,such as checking and guiding the implementation of rules and regulations,guiding occupa-tional protection,management and communication,and implementing HAI management training,professionals with a nursing background had the highest assessment scores(all P＜0.05).Full-time HAI management professionals were relatively satisfied with their training,while those with a background in preventive medicine had lower satisfac-tion with their training,career development,and job benefits(all P＜0.05).Conclusion There are significant differences in the competency of HAI management professionals with different professional backgrounds.It is nece-ssary to optimize division of labor and leverage the strengths,providing ideas and models for promoting the construction of a specialized and professional HAI management team.

Objective:To comprehensively search the relevant literature on prone position-cardiopulmonary resuscitation (PP-CPR) in adults at home and abroad, analyze the content, summarize the evidence, and provide reference for clinical health care professionals.Methods:Systematic search of CNKI, China Biomedical Literature Service System (SinoMed), Wanfang Data, VIP database, PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochran Library, Web of Science, Scopus literature database and other Chinese and English databases was conducted. The search period was from inception to June 15 in 2024. The contents of PP-CPR from randomized controlled trial (RCT), non-RCT (prospective or retrospective), cohort studies and case reports were extracted and systematically analyzed. The search results were standardized by the method of scoping review.Results:A total of 523 articles were obtained through preliminary search, and 14 references and gray literature were retrieved, totaling 537 articles. After strict screening by two researchers, a total of 26 literatures were included, 3 were non-RCT and 23 were case reports, involving 12 countries, including 3 in Chinese, 19 in English, 2 in French, 1 in German, and 1 in Korean. Three non-RCT demonstrated that compared with standard cardiopulmonary resuscitation (CPR), PP-CPR could produce higher pressure, and provide good respiratory and circulatory support. A total of 25 adult patients were included in the 23 case reports, of which 17 reported total recovery time and 13 reported PP-CPR time ≤ 5 minutes, all of which recovered spontaneous circulation, indicating the effectiveness of PP-CPR technology. In terms of final outcome, 4 patients (16.0%) died and 21 patients (84.0%) survived, indicating that PP-CPR technology could provide timely blood circulation and improve clinical outcomes for prone cardiac arrest patients. Among the 11 patients who reported complications after resuscitation, no neurological damage was found in the short-term outcomes, indicating that PP-CPR technology had a certain level of safety.Conclusions:PP-CPR can provide timely blood circulation for patients with cardiac arrest who are unable to lie supine quickly, and win "golden time" for defibrillation and further treatment. In clinical practice, medical staff need to evaluate the emergency environment, the number of rescuers and the specific condition of the patient, and implement first aid as soon as possible, so as to reduce the time of no blood flow in the vital organs of patients with cardiac arrest in prone position, and improve the clinical prognosis.

Objective:To summarize the clinical experience in the diagnosis and treatment of abdominal pregnancy in the sac of lesser omentum after in vitro fertilization and embryo transfer (IVF-ET). Methods:A case of abdominal pregnancy in the sac of lesser omentum after IVF-ET was reported in detail and summarized, and its clinical characteristics were analyzed.Results:After two blastocysts were transplanted 23 d, the patient had a sudden left upper abdominal pain. Ultrasound showed no pregnancy sac in utero, left epigastric dysplasia echo, and a small amount of fluid in the abdominal cavity. Puncture of the posterior vaginal fornix was nonclotting, and there was a clear indication of laparoscopic exploration. After cleaning up the blood in the pelvic and abdominal, the gestational tissue of lesser omentum sac was cleared. The patient recovered well after surgery.Conclusion:Abdominal pregnancy in the sac of lesser omentum after IVF-ET is extremely rare and should be treated timely. Laparoscopic surgery is recommended to determinate abdominal pregnancy in the first trimester.

Objective:To summarize the clinical experience in the diagnosis and treatment of abdominal pregnancy in the sac of lesser omentum after in vitro fertilization and embryo transfer (IVF-ET). Methods:A case of abdominal pregnancy in the sac of lesser omentum after IVF-ET was reported in detail and summarized, and its clinical characteristics were analyzed.Results:After two blastocysts were transplanted 23 d, the patient had a sudden left upper abdominal pain. Ultrasound showed no pregnancy sac in utero, left epigastric dysplasia echo, and a small amount of fluid in the abdominal cavity. Puncture of the posterior vaginal fornix was nonclotting, and there was a clear indication of laparoscopic exploration. After cleaning up the blood in the pelvic and abdominal, the gestational tissue of lesser omentum sac was cleared. The patient recovered well after surgery.Conclusion:Abdominal pregnancy in the sac of lesser omentum after IVF-ET is extremely rare and should be treated timely. Laparoscopic surgery is recommended to determinate abdominal pregnancy in the first trimester.

Objective:To explore the application value of dynamic monitoring of serum soluble interleukin-2 receptor (sIL-2R) and stromal cell-derived factor 1 α (SDF-1α) in patients with acute leukemia (AL).Methods:A total of 187 patients with AL admitted to the Second Hospital of Shanxi Medical University from March 2017 to August 2018 were selected and 90 healthy subjects at the same period were selected as the healthy controls. The levels of serum sIL-2R and SDF-1α were detected at the initial diagnosis, remission phase and relapse phase, respectively. The clinical value of dynamic monitoring of sIL-2R and SDF-1α was analyzed.Results:Among 187 patients with AL, 135 patients (72.19%) had complete remission (CR) after chemotherapy, 52 patients (27.81%) had partial remission, and 43 patients (31.85%) relapsed. The level of serum sIL-2R at the AL initial diagnosis period was (533±32) U/ml, which was higher than that in the healthy controls [(247±30) U/ml], and the difference was statistically significant ( t = 71.976, P < 0.01); the level of serum SDF-1α at the AL initial diagnosis was (2 968±305) pg/ml, which was higher than that in the healthy controls [(1 358±160) pg/ml], and the difference was statistically significant ( t = 47.043, P < 0.01). The levels of serum sIL-2R [(308±30) U/ml] and SDF-1α [(1 576±184) pg/ml] in the CR phase were lower than those in the initial diagnosis of patients with AL; and the levels of sIL-2R [(599±36) U/ml] and SDF-1α [(2 894±301) pg/ml] in the relapse phase were higher than those in the CR phase of patients with AL (all P < 0.01). Conclusions:The levels of serum sIL-2R and SDF-1α in patients with AL are increased, and there are big differences in the levels of sIL-2R and SDF-1α at the initial diagnosis, remission phase, and relapse phase. Dynamic monitoring of both can provide the data support for early clinical intervention.

ObjectiveTo investigate the effect of motivational interviewing on health literacy and quality of life of patients on maintenance hemodialysis. MethodsUsing convenience sampling method, 100 patients on maintenance hemodialysis were selected from March 2016 to March 2018 in a blood purification center of a Class Ⅲ Grade A hospital. According to dialysis time, the patients were divided into the intervention group (n=50) and control group (n=50). Motivational interviews were conducted in the intervention group. Traditional health education methods were used in the control group. The two groups' scores in health literacy and quality of life from Health Literacy of Patients with Chronic Diseases Questionnaire and Kidney Disease Questionnaire(KDQ) before and after intervention were compared. ResultsAfter 6 months of intervention, the total score of health literacy in the intervention group increased from (87.34±2.85) to (97.34±3.02). The scores of three dimensions of "information acquisition ability", "communication and interaction ability" and"willingness to improve health" were higher than those before intervention, and the total score of health literacy and above three dimensions in the intervention group were higher than those in the control group with statistical differences (P＜0.05). The total score of quality of life in the intervention group increased from (100.64±17.62) to (115.60±16.15), among which the scores of "somatic symptoms", "fatigue" and "relationship with others"in the intervention group were higher than those before intervention, and the total score of quality of life and the above three dimensions in the intervention group were higher than those in the control group, the differences were statistically significant (P＜0.05). ConclusionsMotivational interviews can improve the health literacy level of maintenance hemodialysis patients, enhance their awareness of improving health, change their bad behaviors, and improve their quality of life.

Objective:To investigate whether endogenous hydrogen sulfide (H2 S)was involved in the pathogenesis of osteoarthritis (OA)and its underlying mechanism,to detect H2 S and its synthases ex-pression in knee cartilage in patients diagnosed with different severity of OA,and to explore the transcrip-tion and expression of gene MMP-13 in chondrocytes treated with IL-1βor H2S.Methods:Synovial fluids of the in-patients with different severity of OA hospitalized in Peking University First Hospital were collected for measurement of H2 S content using methylene blue assay.Articular cartilages of the patients who underwent knee arthroplasty were collected for the cell culture of relatively normal chondrocytes.The chondrocytes were cultured to the P3 generation and H2 S molecular probes were used for detection of endogenous H2 S generation in the chondrocytes.Immunocytochemistry was used to detect the localization of H2 S synthases including cystathionine β-synthase (CBS),cystathionine-γ-lyase (CSE),and mercap-topyruvate sulfurtransferase (MPST)in OA chondrocytes.Western blot was used to quantify the protein expressions of CSE,MPST,and CBS in cartilage tissues of the patients who were diagnosed with OA and underwent knee arthroplasty.The relatively normal human chondrocytes were cultured to passage 3 and then divided into 4 groups for different treatments:(1 )the normal control group,no reagent was added;(2)the IL-1βgroup,5 μg/L of IL-1βwas added;(3)the IL-1β+H2S group,200 μmol/L of NaHS was added 30 min before adding 5 μg/L of IL-1β;(4)the H2 S group,200 μmol/L of NaHS was added. The transcription and expression of gene MMP-13 in chondrocytes of each group were determined with Real-time PCR and Western blot,respectively.And the total NF-κB p65 and phosphorylated NF-κB p65 in chondrocytes were detected with Western blot.Results:The content of H2 S in the synovial fluid of degenerative knee was (14.3 ±3.3)μmol/L.Expressions of endogenous H2 S and its synthases including CBS,CSE and MPST were present in the cytoplasm of chondrocytes.CSE protein expression in Grade 3 (defined by outerbridge grading)cartilage tissues was significantly increased as compared with that of Grade 1 cartilage tissues (1.67 ±0.09 vs.1.26 ±0.11,P<0.05).However,no significant difference of CBS or MPST expression among the different groups was observed.The expression of MMP-13 protein in the IL-1βgroup was significantly higher than that in the normal chondrocytes (1 .87 ±0.67 vs.0.22 ± 0.10,P<0.05 ),and that in the IL-1β+H2 S group was significantly decreased than that in the IL-1βgroup (0.55 ±0.11 vs.1.87 ±0.67,P<0.05),and that in the H2S group had no significant difference compared with that in the normal control group.The transcription of MMP-13 protein in the IL-1βgroup was significantly higher than that in the normal chondrocytes (31.40 ±0.31 vs.1.00 ±0.00,P<0.05), and that in the IL-1β+H2 S group was significantly decreased than that in the IL-1βgroup (24.41 ± 1.28 vs.31.40 ±0.31,P<0.05),and that in the H2S group had no significant difference compared with that in the normal control group.The total NF-κB p65 in the IL-1βgroup was significantly higher than that in the normal chondrocytes (2.13 ±0.08 vs.0.73 ±0.08,P<0.05),and that in the IL-1β+H2S group was significantly decreased than that in the IL-1βgroup (1 .24 ±0.13 vs.2.13 ±0.08,P<0.05 ),and that in the H2 S group had no significant difference compared with that in the normal control group.The phosphorylated NF-κB p65 in IL-1βgroup was significantly higher than that in the normal chondrocytes (1.30 ±0.13 vs.0.19 ±0.04,P<0.05),and that in IL-1β+H2S group was significantly decreased than that in the IL-1βgroup (0.92 ±0.26 vs.1.30 ±0.13,P<0.05),and that in the H2S group had no significant difference compared with that in the normal control group.Conclusion:H2 S affected the cartilage degeneration by partly inhibiting the degradation of extracellular matrix.

BACKGROUNDAcute lymphoblastic leukemia (ALL) and chemotherapy can cause immune imbalance, and gaseous molecule hydrogen sulfide (H2S) can participate in the process of immune response. This study aimed to investigate the immune regulation of H2S in pediatric ALL.

METHODSChildren (n = 78) with ALL admitted during 2010-2013 were included in this study. Two blood samples were collected in period of before chemotherapy, bone marrow remission and two days after chemotherapy, respectively. Serum contents of H2S and cytokines, including interleukin-1β (IL-1β), interleukin-2 (IL-2), interferon-γ (IFN-γ), tumor necrosis factor (TNF-α), interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-10 (IL-10) and macrophage inflammatory protein-1α (MIP-1α), were detected using ELISA method. Stepwise regression was used to analyze the correlation between H2S and cytokines. Furthermore, human Jurkat cells were cultured in vitro, and nucleoprotein of Jurkat cells and peripheral blood mononuclear cells (PBMCs) were collected, contents of cystathionine γ-lyase (CSE) and certain cytokines were measured by Western blotting.

RESULTSSerum concentrations of H2S, IL-1β, IL-6, IL-10 and MIP-1a in children with ALL were increased significantly (P < 0.01), while concentrations of IL-2, TNF-α, IFN-γ and IL-4 decreased obviously (P < 0.01). In patients after chemotherapy, concentrations of H2S and IL-10 were decreased significantly (P < 0.05), but IL-4 and IFN-γ concentrations increased markedly (P < 0.05). At remission stage, H2S, IL-1β, IL-4, IL-6, IL-10 and MIP-1α concentrations were further decreased markedly (P < 0.05), but concentrations of IL-2, TNF-α and IFN-γ increased again (P < 0.05). Protein contents of CSE, IL-10, IL-4 and IL-2 of PBMCs also increased markedly in children with ALL. Moreover, changes of CSE protein contents of PBMCs were consistent with serum H2S contents, and there were significant correlation between H2S and certain cytokines based on stepwise regression analysis. Furthermore, compared with those of PBMCs group, in vitro study indicated that Jurkat cells of H2S group expressed IFN-γ, IL-10, IL-4 and IL-2 protein increased obviously (P < 0.05), while IL-4, IL-2 and CSE expression of PPG group decreased markedly (P < 0.05).

CONCLUSIONGaseous molecule H2S might participate in the process of immune regulation in pediatric ALL through modulating transcription and expression of cytokines.

Child ; Child, Preschool ; Cystathionine gamma-Lyase ; blood ; Female ; Humans ; Hydrogen Sulfide ; blood ; Interferon-gamma ; blood ; Interleukin-10 ; blood ; Interleukin-1beta ; blood ; Interleukin-2 ; blood ; Interleukin-4 ; blood ; Interleukin-6 ; blood ; Leukocytes, Mononuclear ; metabolism ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; blood ; Tumor Necrosis Factor-alpha ; blood

Aim To study the effect of genistein on contractility of isolated papillary muscles in guinea pig and its mechanisms.Methods Isolated guinea pig papillary muscles were suspended in organ baths containing KH solution,and the effect of genistein on contractility of myocardium was observed after an equilibration period.Results Genistein and isoprenaline hydrochloride showed positive inotropic effects on contractility of myocardium in a dose-dependent manner(1～100 ?mol?L~(-1)) Propranolol(1 ?mol?L~(-1)) and verapamil hydrochloride(0.5 ?mol?L~(-1)) attenuated the positive inotropic effect of isoprenaline hydrochloride(2 ?mol?L~(-1)),but did not change the effect of genistein(100 ?mol?L~(-1)).Furthermore,the enhancement of the contractility induced by elevation of extracellular Ca~(2+) concentration in papillary muscles did not show any change after pretreatment with genistein(1,10 ?mol?L~(-1)).Finally,the positive inotropic effect of genistein was attenuated partially by tamoxifen(1 ?mol?L~(-1)),however,was not influenced by sodium orthovanadate(1 ?mol?L~(-1)).Conclusions Genistein has the positive inotropic effect on guinea pig papillary muscles,which is not related to the activation of Ca~(2+) channel on cell membrane,? adrenoceptor and tyrosine kinase pathway,but this effect may involve in uptake and utilization of sarcoplasmic reticulum Ca~(2+).