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.

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*

This study investigated the therapeutic effects of a low-dose phage cocktail combined with antibiotics on burn wounds in-fected with multidrug resistant Pseudomonas aeruginosa.Given the risk of sepsis caused by drug-resistant bacteria infection after burns and the limitations of antibiotic monotherapy,we constructed a mouse model of burns combined with Pseudomonas aeruginosa infection.A saline control group,phage cocktail monotherapy group,antibiotic monotherapy group,and combined treatment group were examined.The combined treatment group showed a synergistic effect on the 7th day after infection:this group of mice had a sig-nificantly lower pathogenic bacterial load in the skin and liver tissues than observed in the single drug treatment group,and showed the strongest bacterial clearance effect.Histopathological analysis indicated improved structural integrity of the skin tissue,as well as decreased infiltration of inflammatory cells,and no obvious tissue damage,in the combined treatment group.Detection of serum in-flammatory factors indicated that the levels of the pro-inflammatory factors IL-6 and TNF-α significantly decreased,whereas the level of anti-inflammatory factor IL-10 significantly increased.The combination of low-dose phage cocktail and antibiotics synergistically en-hanced antibacterial activity and ameliorated infection through a dual mechanism of direct removal of pathogens and regulation of the host immune response.Our findings provide an experimental basis for the optimal treatment of wounds infected with multidrug-resistant bacteria.

Objective To analyze the dynamic changes and influencing factors of Mycobacterium tuberculosis(TB)infection in grade-1 students in senior high school at the time of enrollment and one year after enrollment.Methods In 2022,TB screening was carried out among grade-2 students in 4 senior high schools in Binhai and Xiqing Districts of Tianjin.Basic information of students was collected,and TB infection detection results of grade-1 students in senior high school at the time of enrollment were collected retrospectively.Positive rate,strong positive rate and positive conversion rate from tuberculin skin test(TST)results of students were compared.Univariate and multiva-riate logistic regression models were used to analyze the relevant influencing factors for positive conversion of TST results.Results The overall positive rate of 1 839 students one year after enrollment was higher than that at the enrollment(46.82％vs 33.12％),while strong positive rate was lower(12.51％vs 13.00％),both with statisti-cally significant differences(both P＜0.001).One year after enrollment,64 out of 1 230 students who were origi-nally negative for TST in their first year of senior high school turned positive,with a positive conversion rate of 5.20％(95％CI:3.93％-6.48％).One year after enrollment,TST results showed that the average diameter of induration was 5(2,8)mm,diameter was 2(0,5)mm at the enrollment of the first year of senior high school,but the difference was not statistically significant(P=0.478).The difference range of average diameter of induration was±21 mm,39.70％of students being within±2 mm.Students with increased and decreased average diameter of induration accounted for 65.09％and 28.49％,respectively.Multivariate logistic regression analysis result showed that students in boarding school had a higher risk of positive conversion compared with non-boarding school students(OR=4.842,95％CI:2.794-8.392).Conclusion The screening of TB infection among grade-2 students in senior high school should be strengthened,with a focus on boarding school students.Early detection of tuberculosis patients and newly infected individuals can provide reference for implementing precise prevention and control.

This study investigated the therapeutic effects of a low-dose phage cocktail combined with antibiotics on burn wounds in-fected with multidrug resistant Pseudomonas aeruginosa.Given the risk of sepsis caused by drug-resistant bacteria infection after burns and the limitations of antibiotic monotherapy,we constructed a mouse model of burns combined with Pseudomonas aeruginosa infection.A saline control group,phage cocktail monotherapy group,antibiotic monotherapy group,and combined treatment group were examined.The combined treatment group showed a synergistic effect on the 7th day after infection:this group of mice had a sig-nificantly lower pathogenic bacterial load in the skin and liver tissues than observed in the single drug treatment group,and showed the strongest bacterial clearance effect.Histopathological analysis indicated improved structural integrity of the skin tissue,as well as decreased infiltration of inflammatory cells,and no obvious tissue damage,in the combined treatment group.Detection of serum in-flammatory factors indicated that the levels of the pro-inflammatory factors IL-6 and TNF-α significantly decreased,whereas the level of anti-inflammatory factor IL-10 significantly increased.The combination of low-dose phage cocktail and antibiotics synergistically en-hanced antibacterial activity and ameliorated infection through a dual mechanism of direct removal of pathogens and regulation of the host immune response.Our findings provide an experimental basis for the optimal treatment of wounds infected with multidrug-resistant bacteria.

Objective To analyze the dynamic changes and influencing factors of Mycobacterium tuberculosis(TB)infection in grade-1 students in senior high school at the time of enrollment and one year after enrollment.Methods In 2022,TB screening was carried out among grade-2 students in 4 senior high schools in Binhai and Xiqing Districts of Tianjin.Basic information of students was collected,and TB infection detection results of grade-1 students in senior high school at the time of enrollment were collected retrospectively.Positive rate,strong positive rate and positive conversion rate from tuberculin skin test(TST)results of students were compared.Univariate and multiva-riate logistic regression models were used to analyze the relevant influencing factors for positive conversion of TST results.Results The overall positive rate of 1 839 students one year after enrollment was higher than that at the enrollment(46.82％vs 33.12％),while strong positive rate was lower(12.51％vs 13.00％),both with statisti-cally significant differences(both P＜0.001).One year after enrollment,64 out of 1 230 students who were origi-nally negative for TST in their first year of senior high school turned positive,with a positive conversion rate of 5.20％(95％CI:3.93％-6.48％).One year after enrollment,TST results showed that the average diameter of induration was 5(2,8)mm,diameter was 2(0,5)mm at the enrollment of the first year of senior high school,but the difference was not statistically significant(P=0.478).The difference range of average diameter of induration was±21 mm,39.70％of students being within±2 mm.Students with increased and decreased average diameter of induration accounted for 65.09％and 28.49％,respectively.Multivariate logistic regression analysis result showed that students in boarding school had a higher risk of positive conversion compared with non-boarding school students(OR=4.842,95％CI:2.794-8.392).Conclusion The screening of TB infection among grade-2 students in senior high school should be strengthened,with a focus on boarding school students.Early detection of tuberculosis patients and newly infected individuals can provide reference for implementing precise prevention and control.

Objective To research superconducting magnetocardiography signal measurement technology and coronary heart disease screening for solving the difficulties in weak magnetocardiography signal measurement,and to verify the value of clinical application.Methods The principle of superconducting magnetocardiography signal measurement technology was analyzed for constructing a framework for superconducting magnetocardiography signal measurement technology.Then,the key circuits such as the host controller,magnetic flux-locked loop,and signal conditioning module were designed,and software systems and core algorithms were developed.Finally,a total of 255 volunteers with healthy hearts,mild myocardial ischemia and severe myocardial ischemia were enrolled in the study,and a comparative experiment was performed between synchronous magnetocardiography and coronary angiography(CAG).Results The peer-to-peer bipolar structure was only observed in the current density vector distribution of healthy subjects instead of myocardial ischemia subjects.The overall coincidence rate,total Kappa value,severe ischemia coincidence rate,mild ischemia coincidence rate and negative coincidence rate of magnetocardiography with CAG were 86.22%,78.21%,86.79%,84.09%and 86.67%,respectively.Magnetocardiography had a sensitivity,specificity,positive rate,negative rate,positive likelihood ratio and negative likelihood ratio of 87.16%,84.41%,86.00%,86.67%,5.98 and 0.08,respectively.Conclusion Magnetocardiography has a high coincidence rate and consistency with CAG in the diagnosis of myocardial ischemia.Superconducting magnetocardiography signal measurement technology can be served as an accurate and reliable screening method for coronary heart diseases.

Background The incidence rate of missed abortion is increasing year by year, but the etiology has not been fully elucidated. Adverse pregnancy history and exposure to polycyclic aromatic hydrocarbons (PAHs) may increase the risk of missed abortion. Objective To investigate the interaction between adverse pregnancy history and PAHs exposure on missed abortion in early pregnancy, and to provide evidence for the etiologic research of missed abortion. Methods A total of 114 pregnant women diagnosed with missed abortion in the Department of Obstetrics of the First Hospital of Shanxi Medical University from March to December 2019 were selected as the case group, and 139 pregnant women who visited the same hospital for voluntary induced abortion in the same period as the control group, to collect basic information and medical information of abortion, stillbirth, intrauterine growth retardation, and other adverse pregnancy history. Abortion villus tissues were collected to detect PAH-DNA adducts levels, stratified by pregnancy and adverse pregnancy history and grouped by quartile method: Q₁ (< 404.61 ng·L⁻¹), Q₂ (404.61−453.75 ng·L⁻¹), Q₃ (453.76−506.72 ng·L⁻¹), and Q₄ (≥506.73 ng·L⁻¹). SPSS 25.0 statistical software was used for χ² test and multiple logistic regression, and additive and multiplicative models were used to investigate the interaction between adverse pregnancy history and PAH-DNA adducts level on missed abortion. The PAH-DNA adducts were grouped by tertiles and quartiles, and P₃₃, P₅₀, P₆₇ and P₇₅ were used as data cut points for sensitivity analysis. Results The proportion of adverse pregnancy history in the case group (32.46%) was higher than that in the control group (12.23%) (P < 0.001). Among 160 subjects with≥2 pregnancies, the proportion of adverse pregnancy history in the case group (57.81%) was higher than that in the control group (17.71%) (P < 0.001). The results of χ² test stratified by pregnancy for different PAH-DNA adducts levels between the two groups showed that the PAH-DNA adducts level was associated with missed abortion in subjects with≥2 pregnancies (χ²=10.14, P=0.017). Being further stratified by adverse pregnancy history, the PAH-DNA adducts level in subjects with no adverse pregnancy history was associated with missed abortion (χ²=9.70, P=0.021). The results of logistic regression analysis showed that adverse pregnancy history (OR=5.88, 95%CI: 2.79−12.39) and PAH-DNA adducts (OR=3.01, 95%CI: 1.22−7.40) increased the risk of missed abortion, but no interaction between them was found. The relative excess risk of interaction (RERI), the attributable percentage of interaction (AP), and the synergy index (SI) and its 95%CI were 0.60 (95%CI: −0.58−1.77), 0.74 (95%CI: −0.83−2.30), and 0.20 (95%CI: 0.01−5.43), respectively. Conclusions Adverse pregnancy history and PAH-DNA adducts in pregnant women may increase the risk of missed abortion. The effect of the interaction between them on the occurrence of missed abortion is not supported by the current study.

The delivery of exogenous insulin is very important for the treatment of type 1 and advanced type 2 diabetes.Traditional injectable administration is prone to cause hypoglycemia, while the intelligent insulin system has the advantages of safety, long-term effectiveness, and high responsiveness.Glucose oxidase (GOx) can consume O2 and catalyze glucose to produce gluconic acid and H2O2.Therefore, the O2 level, H2O2 content and pH of GOx system are closely related to the glucose level in the system.This review introduces the application of GOx in closed-loop insulin delivery systems at home and abroad in recent years, which can be divided into single response and multiple response of pH-response, hypoxia-response, and H2O2-response according to the mechanism.It also discusses the opportunities and challenge facing by the application of GOx in the future.

De novo variants (DNVs) are one of the most significant contributors to severe earlyonset genetic disorders such as autism spectrum disorder, intellectual disability, and other developmental and neuropsychiatric (DNP) disorders. Presently, a plethora of DNVs have been identified using next-generation sequencing, and many efforts have been made to understand their impact at the gene level. However, there has been little exploration of the effects at the isoform level. The brain contains a high level of alternative splicing and regulation, and exhibits a more divergent splicing program than other tissues. Therefore, it is crucial to explore variants at the transcriptional regulation level to better interpret the mechanisms underlying DNP disorders. To facilitate a better usage and improve the isoform-level interpretation of variants, we developed NeuroPsychiatric Mutation Knowledge Base (PsyMuKB). It contains a comprehensive, carefully curated list of DNVs with transcriptional and translational annotations to enable identification of isoformspecific mutations. PsyMuKB allows a flexible search of genes or variants and provides both table-based descriptions and associated visualizations, such as expression, transcript genomic structures, protein interactions, and the mutation sites mapped on the protein structures. It also provides an easy-to-use web interface, allowing users to rapidly visualize the locations and characteristics of mutations and the expression patterns of the impacted genes and isoforms. PsyMuKB thus constitutes a valuable resource for identifying tissue-specific DNVs for further functional studies of related disorders. PsyMuKB is freely accessible at http://psymukb.net.