ObjectiveTo establish a regional risk assessment system for hospital-acquired infections in neurosurgery department of general hospital, and to evaluate its prevention and control effectiveness. MethodsFailure mode and effect analysis (FMEA) was used to identify the core risk factors for infections in neurosurgery department. The risk priority number (RPN) of each risk factor was calculated to determine the priority intervention targets. Targeted interventions were developed and continuously refined through the plan-do-check-act (PDCA) cycles. Data from January to June 2023 (control group) and July to December 2023 (intervention group) were collected to compare the differences in environmental hygiene monitoring qualification rate, incidence rate of hospital-acquired infections among inpatients, and detection rate of bacterial antimicrobial resistance. ResultsHigh-risk factors for hospital-acquired infections in neurosurgery department included patient-related risk factors, inadequate implementation of isolation measures for special infections, and poor compliance with surgical site infection (SSI) prevention protocols. After intervention, the environmental hygiene qualification rate significantly increased from 81.55% to 100.00% (χ²=120.49, P<0.001). The overall hospital-acquired infection rate among inpatients decreased from 2.62% to 2.45%, the infection rate of per case declined from 3.12% to 2.84%, and the detection rate of multidrug-resistant organism infections reduced from 43.72% to 36.79%. Additionally, antimicrobial utilization rate decreased from 48.75% to 42.53% (χ²=34.09, P<0.001). ConclusionThe FMEA-based risk assessment system can effectively identify critical infection risks in neurosurgery department, and targeted interventions can significantly improve infection prevention and control performance.

ObjectiveCurrently， evidence regarding whether the left or right nostril should be preferentially selected for nasotracheal intubation （NTI） in children remains insufficient， particularly under continuous visualization conditions. This study aimed to compare the efficiency and safety of NTI via the left versus right nostril in children under flexible intubation video endoscope （FIVE） guidance. MethodsA total of 100 children aged 3-7 years with American Society of Anesthesiologists physical status I-II， who were scheduled for elective dental caries treatment under general anesthesia， were randomly assigned to undergo FIVE-guided NTI via either the left nostril （group L） or the right nostril （group R）. The primary outcome was intubation time. Secondary outcomes included first-attempt success rate， number of intubation attempts， incidence and severity of epistaxis， peri-intubation hemodynamic and respiratory parameters， and postoperative procedure-related complications （nasal blockage， sore throat， and hoarseness）. ResultsNo statistically significant between-group difference was found in intubation time （L group： 36.86 ± 6.04 s vs. R group： 37.96 ± 6.20 s； P=0.371） or first-attempt success rate （96% vs. 92%， respectively； P=0.400）. The incidence and severity of epistaxis were comparable between groups （10% vs. 12%； P=0.749）. No statistically significant between-group differences were observed in hemodynamic and respiratory parameters at all measured time points （all P>0.05）. The incidences of postoperative nasal congestion， sore throat， and hoarseness were low in both groups. ConclusionIn children undergoing FIVE-guided NTI， tracheal catheter insertion via the left or right nostril yields comparable efficacy and safety. When using visualization-guided techniques in routine pediatric clinical practice， nostril laterality does not need to be prioritized when selecting the insertion side for NTI.

Objective:To analyze the wear rate of each monitoring module of monitoring device during the duration of wearing monitoring device in patients who received monitoring for vital sign,and research the application value of that in clinical treatment and its influence on patients'compliance.Methods:A total of 200 patients with emergency observation who need undergo monitoring for vital sign at Ningbo Medical Center Li Huili Hospital from July to December 2024 were selected.They were divided into a bedside monitoring group and a wearable monitoring group,with 100 patients in each group.The bedside monitoring group used conventional bedside monitoring devices for treatment and monitoring,while the wearable monitoring group used wearable monitoring devices for that.Boxplot was utilized to compare the wear rates of each module of the monitoring devices between the two groups,and to analyze patients'compliance.Results:The median of wear rates of the electrocardiogram(ECG)module and the blood oxygen module were respectively 0.991(0.975,0.999)and 0.928(0.876,0.979)in the wearable monitoring group,which were significantly higher than the 0.846(0.811,0.881)and 0.699(0.641,0.754)of the bedside monitoring group(Z=10.586,5.065,P<0.05).The wear rates of the monitoring devices for monitoring indicators such as heart rate,blood oxygen,perfusion index,respiratory frequency and pulse in the wearable monitoring group were also higher than those in the bedside monitoring group,with statistically significant differences(t=10.586,5.065,5.067,8.731,5.063,P<0.05).However,there was not significant difference in the wear rate of monitoring device for blood pressure between two groups(P>0.05).Conclusion:Wearable monitoring can effectively improve patients'wear rates,and enhance patients'compliance,and prolong monitoring time for patients,and improve treatment outcomes for patients,and ensure the life and health of patients.

Objective To investigate the correlations of the expression levels of serum microR-NA-374b-5p(miR-374b-5p),P-selectin and tumor necrosis factor receptor-associated factor 6(TRAF6)with deep vein thrombosis(DVT)in patients with traumatic lower limb fractures,and to construct a multi-indicator Logistic regression model to establish a postoperative DVT risk prediction tool.Methods A total of 160 patients with traumatic lower limb fractures were selected as the study subjects and divided into DVT group(n=55)and non-DVT group(n=105)based on postoperative color Doppler ultrasound examination results.Clinical data of the patients were collected,and their coagulation and blood lipid indicators were tested.Real-time fluorescent quantitative polymerase chain reaction was used to detect the serum miR-374b-5p expression level within 24 hours postopera-tively.Enzyme-linked immunosorbent assay(ELISA)was employed to measure serum P-selectin and TRAF6 levels,and their relationships with short-term postoperative DVT were analyzed.Logis-tic regression analysis was conducted to identify the influencing factors of postoperative DVT in pa-tients with traumatic lower limb fractures,and a relevant model was established to assess the pa-tients' DVT risk.Results There were no statistically significant differences in demographic charac-teristics(gender,age and body mass index),underlying diseases(hypertension,diabetes and vari-cose veins),treatment-related factors(postoperative hemostatic drug use and fracture site),and lif-estyle habits(smoking history and alcohol consumption history)between the two groups(P＞0.05).The proportion of patients in the DVT group with a postoperative first ambulation time of less than 7 days was significantly lower than that in the non-DVT group,while the levels of D-dimer and fibrinogen degradation products were significantly higher in the DVT group than those in the non-DVT group(P＜0.05).The high-density lipoprotein cholesterol level in the DVT group was signifi-cantly lower than that in the non-DVT group(P＜0.05).The relative expression levels of serum miR-374b-5p and the levels of P-selectin and TRAF6 in the DVT group were significantly higher than those in the non-DVT group(P＜0.05).Logistic regression analysis revealed that a postopera-tive ambulation time of≥7 days,D-dimer,fibrinogen degradation products,high-density lipopro-tein cholesterol,relative expression level of miR-374b-5p as well as levels of P-selectin and TRAF6 were influencing factors for postoperative DVT in patients.Based on these findings,a postoperative DVT prediction model was established,which showed an area under the curve(AUC)of 0.977(95％CI:0.953 to 0.992)for predicting postoperative DVT in patients.Conclusion The serum levels of miR-374b-5p,P-selectin and TRAF6 are closely related to postoperative DVT in patients with traumatic lower limb fractures,and the prediction model established based on these factors has high predictive value.

Objective::This study aimed to explore the causal link between olive intake and the occurrence of coronary heart disease (CHD) using Mendelian randomization (MR).Methods::In this study, genome-wide association study data from IEU OpenGWAS were employed. A 2-sample MR analysis was used to determine the causal association of olive intake with CHD and cardiovascular outcomes (myocardial infarction, heart failure, stroke, and death due to cardiac causes). The data for olive intake included 64,949 samples and 9,851,867 single nucleotide polymorphisms (SNPs), the data for CHD included 361,194 samples and 13,295,130 SNPs; The data for myocardial infarction included 361,194 samples and 12,640,541 SNPs, the heart failure include 208,178 samples and 16,380,422 SNPs, the data for stroke included 361,194 samples and 12,404,026 SNPs, and the data for death due to cardiac causes included 361,194 samples and 10,071,648 SNPs. Additionally, a 2-step, 2-sample MR approach was used for mediation analysis to determine whether lipid traits mediate the causal association between olive intake and CHD. The data for total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, apolipoprotein B, and apolipoprotein A1 included 115,078 samples and 12,321,875 SNPs, while the data for triglycerides included 21,545 samples and 11,871,391 SNPs. Cochran’s Q test was applied to examine potential heterogeneity, and the MR-Egger method was used to assess horizontal pleiotropy among SNPs. Leave-one-out analysis was performed as a sensitivity analysis to evaluate the robustness of the results. Results::For each standard deviation increase in olive intake, the risk of CHD decreased by a substantial 1.9% (odds ratio (OR) = 0.981, 95% confidence interval (CI): 0.963 to 0.998, P = 0.031), the risk of myocardial infarction was significantly reduced by 1.6% (OR = 0.984, 95% CI: 0.969 to 0.999, P = 0.032), and the risk of heart failure declined by 62.1% (OR = 0.379, 95% CI: 0.192 to 0.746, P = 0.005). Furthermore, mediation analysis with MR indicated that lipid traits did not mediate the causal relationship between olive intake and CHD. Conclusion::There is a negative correlation between olive intake and the incidence of CHD, and this relationship is not mediated by lipid traits. Olive intake was also negatively associated with some cardiovascular outcomes, suggesting that increasing olive intake holds significant value in preventing the onset and progression of CHD.

In October 2024， the 75th World Medical Association General Assembly adopted the tenth revised version of the Declaration of Helsinki. Using textual analysis， this paper systematically compared the changes between the 2024 version and the 2013 version of the Declaration of Helsinki. This study found that， while maintaining the original framework， the new version incorporated the common achievements of the values and civilizational development of human society in recent years， mainly presenting changes in three aspects. First， the core terms were updated， and new concepts such as vulnerability， structural inequality， and environmental sustainability were introduced to further emphasize human dignity， rights and interests， and autonomy in terms of values. Second， the contents of the provisions were refined， especially focusing on the vulnerability of research subjects， free and full informed consent， ethical principles in public health emergencies， and the responsibilities of the ethics committee， as well as the standardization of implementation continued to be improved in the research process. Third， mandatory expressions were strengthened， and the justice of value pursuit was further reinforced in terms of research responsibilities. The revised contents reflected the “human-oriented” fundamental principle in medical research ethics， indicating the direction for future ethical development in medical research. In the future， China should strengthen the construction of ethics committees， actively build a protection system for research participants， and continuously promote international cooperation in medical ethics， to contribute Chinese wisdom to global medical research.

[Objective] To investigate the non-pathological influencing factors of the unqualified alanine aminotransferase (ALT) in the initial screening of blood donors in Changchun and the laboratory re-examination, so as to provide evidence for reducing the deferral of blood donors and the discarding of blood due to ALT disqualification. [Methods] The unqualified results of ALT from the laboratory of our center from September 1, 2023 to October 31, 2024 were collected. The unqualified rates of ALT were statistically analyzed according to the blood collection sites and the initial screening detection equipment. The samples after ALT pre-donation screening were tested in the laborator, and the unqualified rates of ALT in the initial screening and the laboratory, the non-conformity rate of the results and the distribution range of ALT values were statistically analyzed according to the blood collection sites and the initial screening detection equipment. A questionnaire survey was conducted on the blood donors before blood collection to statistically analyze the influence of the blood donors' living habits and diet on ALT test results. [Results] The statistical analysis of the unqualified rate of ALT in the laboratory showed statistically significant differences in the ALT disqualification rates among different blood collection sites and different initial screening detection devices (P<0.05). Comparison of the ALT unqualified rate for the same type of equipment at different sites showed that for Equipment 1, there were differences between the combined blood collection house and the whole blood house, and between the combined blood collection house and the blood donation vehicle (P<0.05); for Equipment 2, there were differences between the combined blood collection house and the blood donation vehicle, and between the whole blood house and the blood donation vehicle (P<0.05); there were no significant differences among other groups with the same equipment. The initial screening and the laboratory test results for the same samples were compared, with unqualified rates of ALT of 16.29% and 13.01%, respectively. There were statistically significant differences in the unqualified rates of ALT among different blood collection sites (P<0.05), but no significant differences in the ALT test results among different detection equipment (P>0.05).. The non-conformity rate between the initial screening and the laboratory results was 5.26%, of which 81.15% (99/122) were unqualified in the initial screening but qualified in the laboratory. There were statistically significant differences in those unqualified in the initial screening but qualified in the laboratory among different blood collection sites and different detection equipment (P<0.05). The median ALT level in the initial screening was 29.0 U/L (with a 5%-95% range of 14-75 U/L), and the median ALT level in the laboratory was 19 U/L (with a 5%-95% range of 8-65 U/L). The results of the questionnaire survey showed that 33.3% (2/6) of those who consumed alcohol within 24 hours before blood donation had unqualified ALT, and 10% (1/10) of those who stayed up late the night before blood donation had unqualified ALT. [Conclusion] The unqualified rates of ALT in the initial screening before blood collection and the laboratory re-examination of blood donors in Changchun are closely related to the blood collection sites, detection equipment, detection environment, detection personnel, samples, ALT thresholds and detection time. Drinking alcohol and staying up late within 24 hours before blood donation increase the risk of unqualified ALT detection.

Triggering receptor expressed on myeloid cells 2 (TREM2)-mediated microglial phagocytosis is an energy-intensive process that plays a crucial role in amyloid beta (Aβ) clearance in Alzheimer's disease (AD). Energy metabolic reprogramming (EMR) in microglia induced by TREM2 presents therapeutic targets for cognitive impairment in AD. Jiawei Xionggui Decoction (JWXG) has demonstrated effectiveness in enhancing energy supply, protecting microglia, and mitigating cognitive impairment in APP/PS1 mice. However, the mechanism by which JWXG enhances Aβ phagocytosis through TREM2-mediated EMR in microglia remains unclear. This study investigates how JWXG facilitates microglial phagocytosis and alleviates cognitive deficits in AD through TREM2-mediated EMR. Microglial phagocytosis was evaluated through immunofluorescence staining in vitro and in vivo. The EMR level of microglia was assessed using high-performance liquid chromatography (HPLC) and enzyme-linked immunosorbent assay (ELISA) kits. The TREM2/protein kinase B (Akt)/mammalian target of rapamycin (mTOR)/hypoxia-inducible factor-1α (HIF-1α) signaling pathway was analyzed using Western blotting in BV₂ cells. TREM2^-/- BV₂ cells were utilized for reverse validation experiments. The Aβ burden, neuropathological features, and cognitive ability in APP/PS1 mice were evaluated using ELISA kits, immunohistochemistry (IHC), and the Morris water maze (MWM) test. JWXG enhanced both the phagocytosis of EMR disorder-BV₂ cells (EMRD-BV₂) and increased EMR levels. Notably, these effects were significantly reversed in TREM2^-/- BV₂ cells. JWXG elevated TREM2 expression, adenosine triphosphate (ATP) levels, and microglial phagocytosis in APP/PS1 mice. Additionally, JWXG reduced Aβ-burden, neuropathological lesions, and cognitive deficits in APP/PS1 mice. In conclusion, JWXG promoted TREM2-induced EMR and enhanced microglial phagocytosis, thereby reducing Aβ deposition, improving neuropathological lesions, and alleviating cognitive deficits.
Drugs, Chinese Herbal/pharmacology* ; Microglia/drug effects* ; Phagocytosis ; Cognitive Dysfunction/drug therapy* ; Metabolic Reprogramming ; Animals ; Mice ; Cell Line ; Receptors, Immunologic/metabolism* ; Membrane Glycoproteins/metabolism* ; Signal Transduction ; Amyloid beta-Peptides/metabolism* ; Energy Metabolism

The high content of sucrose and raffinose reduces the prebiotic value of soybean oligosaccharides. Fructan sucrases can catalyze the conversion of sucrose and raffinose to high-value products such as fructooligosaccharides and melibiose. To obtain a fructan sucrase that can efficiently convert soybean oligosaccharides, we first mined the fructan sucrase gene from microorganisms in the coastal areas of Xisha Islands and Bohai Bay and then characterized the enzymatic and catalytic properties of the enzyme. Finally, recombinant extracellular expression of this gene was carried out in Bacillus subtilis. The results showed that a novel fructan sucrase, BhLS 39, was mined from Bacillus halotolerans. With sucrose and raffinose as substrates, BhLS 39 showed the optimal temperatures of 50 ℃ and 55 ℃, optimal pH 5.5 for both, and K_cat/K_m ratio of 3.4 and 6.6 L/(mmol·s), respectively. When 400 g/L raffinose was used as the substrate, the melibiose conversion rate was 84.6% after 30 min treatment with 5 U BhLS 39. Furthermore, BhLS 39 catalyzed the conversion of sucrose to produce levan-type-fructooligosaccharide and levan. Then, the recombinant extracellular expression of BhLS 39 in B. subtilis was achieved. The co-expression of the intracellular chaperone DnaK and the extracellular chaperone PrsA increased the extracellular activity of the recombinant BhLS 39 by 5.2 folds to 17 U/mL compared with that of the control strain. BhLS 39 obtained in this study is conducive to improving the quality and economic benefits of soybean oligosaccharides. At the same time, the strategy used here to enhance the extracellular expression of BhLS 39 will also promote the efficient recombinant expression of other proteins in B. subtilis.
Oligosaccharides/metabolism* ; Glycine max/metabolism* ; Bacillus subtilis/metabolism* ; Sucrase/biosynthesis* ; Raffinose/metabolism* ; Fructans/metabolism* ; Sucrose/metabolism* ; Bacillus/genetics* ; Recombinant Proteins/biosynthesis* ; Bacterial Proteins/biosynthesis*

Objective:To explore the mediating effect of psychological resilience between perceived stress and job burnout among standardized gastroenterology nursing training students.Methods:A total of 156 nursing trainees who received standardized training in the Department of Gastroenterology at Shaanxi Provincial People's Hospital between December 2022 and July 2024 were selected by the convenience sampling method. Data were collected using a general information questionnaire, the Connor-Davidson Resilience Scale, the Chinese Perceived Stress Scale, and the Maslach Burnout Inventory-General Survey. A Pearson correlation analysis was used to examine the relationship among perceived stress, psychological resilience, and job burnout in standardized gastroenterology nursing training students. AMOS 24.0 statistical software was used to construct a structural equation model to analyze the mediating effect of psychological resilience between perceived stress and job burnout in standardized gastroenterology nursing training students. The bias-corrected bootstrap method was applied to test the mediating effect of psychological resilience.Results:The averaged total scores of 156 standardized gastroenterology nursing training students were (29.89±0.30) for perceived pressure, (62.45±2.44) for psychological resilience, and (57.85±3.44) for job burnout. Of the trainees, 88 (56.41%) exhibited job burnout, including 39 (25.00%) with mild burnout, 41 (26.28%) with moderate burnout, and 8 (5.13%) with severe burnout. The Pearson correlation analysis showed that perceived stress was positively correlated with job burnout ( r=0.543, P<0.05) and negatively correlated with psychological resilience ( r=-0.443, P<0.05), and psychological resilience was negatively correlated with job burnout ( r=-0.478, P<0.05). The results of bias-corrected bootstrap test showed that psychological resilience had a partial mediating effect between perceived stress and job burnout among standardized gastroenterology nursing training students ( P<0.05), accounting for 32.63% of the total effect. Conclusions:Moderate job burnout was observed in standardized gastroenterology nursing training students. Job burnout was closely related to perceived stress and psychological resilience. Psychological resilience partly mediated the relationship between perceived stress and job burnout. Therefore, clinical managers may alleviate the perceived psychological pressure and subsequently reduce the occurrence of job burnout among standardized nursing training students by increasing psychological resilience.