Objective To understand the current status of healthcare-associated infection(HAI)management for transesophageal echocardiography(TEE)examination in China,and provide a scientific basis for formulating guide-lines and standards for infection prevention and control in ultrasound diagnosis and treatment.Methods A stratified sampling survey was conducted in 162 medical institutions(MIs)in 14 provinces(autonomous regions,municipali-ties)in China.A unified questionnaire was designed,and on-site surveys were conducted in the TEE examination room of each MI,with questionnaires filled out based on the results of the on-site survey.Results 162 MIs were surveyed,out of which 114(70.4％)carried out TEE examination.TEE examination was undertaken by ultrasound medicine department(66.7％)and cardiology department(36.0％)in most MIs,and 91.0％of HAI departments had specially-assigned infection prevention and control professional to responsible for the management of HAI rela-ted to examination.32.4％(n=36)of TEE examinations used ultrasound probe isolation sleeves,mainly sterilized isolation membranes.The overall high-level disinfection or sterilization rate of TEE probes was 79.3％,19.8％of MIs chose medium-level disinfection.However,based on the number of equipped probes,the interval between pa-tient examination,and the disinfection method of probes,it was inferred that the proportion of effective high-level disinfection was only 67.6％.The most commonly adopted sterilization,high-level disinfection and medium-low le-vel disinfection methods for probes were low-temperature hydrogen peroxide sterilization,o-phthalaldehyde disinfec-tion and quaternary ammonium wiping disinfection,respectively.92.8％of examination rooms stored the probes in special storages cabinets(boxes)after disinfection.32.4％of examination rooms cleaned and disinfected ultrasound devices other than TEE probe between each patient examination,all were with medium-level disinfection.Most exa-mination rooms equipped complete hand hygiene(HH)facilities and ventilation,59.5％of the operators had the HH compliance rate of more than 90％.The wearing of disposable medical rubber examination gloves and glove changing for each patient was ideal.However,the change of bedding and the change of medical operators'overalls for each patient were not ideal.Conclusion TEE examination is generally carried out in large MIs across the coun-try,but the high-level disinfection rate of TEE probes still needs to be improved,and the appropriate disinfection methods still need further discussion and research.The disinfection awareness of ultrasound devices other than TEE probes still needs to be enhanced,and the compliance of hand hygiene of operators,the awareness of timely chan-ging of bedding of patients'examination beds,and the awareness of changing of overalls of diagnosis and treatment operators need to be enhanced.

Medical ultrasound technology is widely used for diagnosis and therapy in clinical practice.Ultrasound probes,which are directly contact with patients,pose a potential risk of pathogen transmission.This expert consen-sus was developed by a multidisciplinary team based on international guidelines,standards in China,and the results of a national survey,aiming to reduce the risk of healthcare-associated infection through standardizing reprocessing of medical ultrasound probes,and formulating consensus recommendations with the Delphi method.The consensus clarifies the reprocessing principles for three types of ultrasound probes of different infection risks:external-use ul-trasound probes,interventional percutaneous ultrasound probes,and internal-use ultrasound probes,puts forward systematic suggestions on the reprocessing standards and disinfection levels of ultrasound probe isolation covers and coupling agents,the reprocessing procedures and methods of ultrasound probes,as well as architectural layout and management of reprocessing,so as to provide a scientific prevention and control framework for ensuring ultrasound diagnosis and therapy safety.

BACKGROUND:Percutaneous kyphoplasty assisted by C-arm under local anesthesia requires continuous adjustment of the puncture direction under multiple C-arm fluoroscopy.The establishment time of the working channel is longer,and the intraoperative pain stimulation of patients is larger.With the help of the robot,the puncture can be successfully performed at one time,which can significantly improve the experience of patients and reduce the risk of bone cement leakage.OBJECTIVE:To compare the patient experience and other outcomes of percutaneous kyphoplasty using robot-assisted and conventional C-arm fluoroscopy under local anesthesia.METHODS:A total of 241 patients with single-stage osteoporotic vertebral compression fracture were selected from Sichuan Academy of Medical Sciences·Sichuan Provincial People's Hospital(Affiliated Hospital,University of Electronic Science and Technology of China).132 patients underwent robot-assisted percutaneous kyphoplasty under local anesthesia(robot-assisted group).109 cases of conventional C-arm assisted percutaneous kyphoplasty under local anesthesia(conventional fluoroscopy group).Patients'intraoperative experience evaluation,bone cement injection amount,operation time,working channel establishment time,hospitalization cost and complications were recorded.Puncture deviation and bone cement leakage were evaluated by imaging on the first day after surgery.RESULTS AND CONCLUSION:(1)The intraoperative experience of 59 patients in the robot-assisted group was rated as"very good",43 as"good",16 as"average",10 as"poor",and 4 as"very poor,"while that of 30 patients in the conventional fluoroscopy group was rated as"very good",44 cases were"good",21"average",9"poor",and 5"very poor."There was a significant difference between the two groups in intraoperative experience evaluation(Z=-2.546,P=0.011).Intraoperative pain visual analog scale score was lower in the robot-assisted group than that in the conventional fluoroscopy group(t=-9.513,P=0.000).Totally 84 patients in the robot-assisted group and 47 patients in the conventional fluoroscopy group were willing to undergo percutaneous kyphoplasty again when necessary,and there was a significant difference between the two groups(Z=-2.730,P=0.006).(2)The operation time and hospitalization cost of the robot-assisted group were more than those of the conventional fluoroscopy group(t=2.860,P=0.003;t=36.522,P=0.000).The working channel establishment time of robot-assisted group was shorter than that of conventional fluoroscopy group(t=-27.066,P=0.000).The puncture deviation of robot-assisted group was better than that of conventional fluoroscopy group(Z=-3.656,P=0.000).The cement leakage of robot-assisted group was lower than that of conventional fluoroscopy group(χ2=7.284,P=0.007).(3)It is concluded that under local anesthesia,patients with robot-assisted percutaneous kyphoplasty have good surgical experience,with advantages of accurate puncture,short time to establish working channel,and low leakage rate of bone cement.

Objective To develop the Perceived Spouse Support Scale for pregnant women in the second and third trimester of pregnancy and test its reliability and validity,so as to provide an effective tool for assessing the perceived spouse support level of pregnant women.Methods With social support theory as the theoretical framework,the questionnaire item pool was initially constructed through literature review and semi-structured interview,and the initial questionnaire was formed through expert correspondence and cognitive interview.From April to November 2023,570 pregnant women in the second and third trimester of pregnancy were selected by random sampling method for investigation,item analysis and reliability and validity test of the scale.Results Eventually 558 pregnant women completed the suivey.The Perceived Spouse Support Scale for pregnant women in the second and third trimesters contained 22 items,including instrumental support,informational support and emotional support.The Cronbach's α coefficient of the scale was 0.867;the split-half reliability was 0.793;the retest reliability was 0.965;the content validity index was 0.980.The cumulative variance contribution rate of the 3 common factors was 54.138％.Confirmatory factor analysis suggested that the model fit well.Conclusion The Perceived Spouse Support Scale has good reliability and validity,and it can be used as an evaluation tool for spouse support level of pregnant women.

Astragali Radix (AR), a traditional Chinese medicine (TCM), has demonstrated therapeutic efficacy against various diseases, including cardiovascular conditions, over centuries of use. While doxorubicin serves as an effective chemotherapeutic agent against multiple cancers, its clinical application remains constrained by significant cardiotoxicity. Research has indicated that AR exhibits protective properties against doxorubicin-induced cardiomyopathy (DIC); however, the specific bioactive components and underlying mechanisms responsible for this therapeutic effect remain incompletely understood. This investigation seeks to identify the protective bioactive components in AR against DIC and elucidate their mechanisms of action. Through network medicine analysis, astragaloside IV (AsIV) and formononetin (FMT) were identified as potential cardioprotective agents from 129 AR components. In vitro experiments using H9c2 rat cardiomyocytes revealed that the AsIV-FMT combination (AFC) effectively reduced doxorubicin-induced cell death in a dose-dependent manner, with optimal efficacy at a 1∶2 ratio. In vivo, AFC enhanced survival rates and improved cardiac function in both acute and chronic DIC mouse models. Additionally, AFC demonstrated cardiac protection while maintaining doxorubicin's anti-cancer efficacy in a breast cancer mouse model. Lipidomic and metabolomics analyses revealed that AFC normalized doxorubicin-induced lipid profile alterations, particularly by reducing fatty acid accumulation. Gene knockdown studies and inhibitor experiments in H9c2 cells demonstrated that AsIV and FMT upregulated peroxisome proliferator activated receptor γ coactivator 1α (PGC-1α) and PPARα, respectively, two key proteins involved in fatty acid metabolism. This research establishes AFC as a promising therapeutic approach for DIC, highlighting the significance of multi-target therapies derived from natural herbals in contemporary medicine.
Animals ; Doxorubicin/adverse effects* ; Saponins/administration & dosage* ; Isoflavones/pharmacology* ; Rats ; Cardiomyopathies/prevention & control* ; Mice ; Fatty Acids/metabolism* ; Myocytes, Cardiac/metabolism* ; Triterpenes/administration & dosage* ; Male ; Drugs, Chinese Herbal/administration & dosage* ; Humans ; Cardiotonic Agents/administration & dosage* ; Mice, Inbred C57BL ; Cell Line ; Astragalus Plant/chemistry* ; Astragalus propinquus

Objective:To systematically evaluate and synthesize qualitative studies of life experiences and needs of patients after cardiac pacemaker implantation and provide a reference for developing targeted care plans.Methods:A search of qualitative studies of life experiences and needs of patients after cardiac pacemaker implantation were conducted in PubMed, Web of Science, Embase, Cochrane Library, PsycINFO, CINAHL, China National Knowledge Infrastructure, Wanfang Data, VIP and China Biology Medicine disc, from the time of the database construction to March 25, 2024. The quality of the studies were assessed using the criteria for evaluating the qualitative research quality of the Australia Joanna Briggs Institute Evidence-Based Health Care Centre, and the findings were synthesized using Meta-synthesis methods.Results:Eight studies were included, resulting in 40 themes, which were grouped into eight categories and synthesized into three main findings: symptom distress affected patients' quality of life, patients gradually adopted to pacemakers and adopted positive coping strategies, and patients expressed expectations for external support systems.Conclusions:Patients after cardiac pacemaker implantation experience diminished self-awareness and fear of early physical activity. Healthcare providers should assist patients in developing positive coping strategies.

Objective To understand the current status of healthcare-associated infection(HAI)management for transesophageal echocardiography(TEE)examination in China,and provide a scientific basis for formulating guide-lines and standards for infection prevention and control in ultrasound diagnosis and treatment.Methods A stratified sampling survey was conducted in 162 medical institutions(MIs)in 14 provinces(autonomous regions,municipali-ties)in China.A unified questionnaire was designed,and on-site surveys were conducted in the TEE examination room of each MI,with questionnaires filled out based on the results of the on-site survey.Results 162 MIs were surveyed,out of which 114(70.4％)carried out TEE examination.TEE examination was undertaken by ultrasound medicine department(66.7％)and cardiology department(36.0％)in most MIs,and 91.0％of HAI departments had specially-assigned infection prevention and control professional to responsible for the management of HAI rela-ted to examination.32.4％(n=36)of TEE examinations used ultrasound probe isolation sleeves,mainly sterilized isolation membranes.The overall high-level disinfection or sterilization rate of TEE probes was 79.3％,19.8％of MIs chose medium-level disinfection.However,based on the number of equipped probes,the interval between pa-tient examination,and the disinfection method of probes,it was inferred that the proportion of effective high-level disinfection was only 67.6％.The most commonly adopted sterilization,high-level disinfection and medium-low le-vel disinfection methods for probes were low-temperature hydrogen peroxide sterilization,o-phthalaldehyde disinfec-tion and quaternary ammonium wiping disinfection,respectively.92.8％of examination rooms stored the probes in special storages cabinets(boxes)after disinfection.32.4％of examination rooms cleaned and disinfected ultrasound devices other than TEE probe between each patient examination,all were with medium-level disinfection.Most exa-mination rooms equipped complete hand hygiene(HH)facilities and ventilation,59.5％of the operators had the HH compliance rate of more than 90％.The wearing of disposable medical rubber examination gloves and glove changing for each patient was ideal.However,the change of bedding and the change of medical operators'overalls for each patient were not ideal.Conclusion TEE examination is generally carried out in large MIs across the coun-try,but the high-level disinfection rate of TEE probes still needs to be improved,and the appropriate disinfection methods still need further discussion and research.The disinfection awareness of ultrasound devices other than TEE probes still needs to be enhanced,and the compliance of hand hygiene of operators,the awareness of timely chan-ging of bedding of patients'examination beds,and the awareness of changing of overalls of diagnosis and treatment operators need to be enhanced.

Medical ultrasound technology is widely used for diagnosis and therapy in clinical practice.Ultrasound probes,which are directly contact with patients,pose a potential risk of pathogen transmission.This expert consen-sus was developed by a multidisciplinary team based on international guidelines,standards in China,and the results of a national survey,aiming to reduce the risk of healthcare-associated infection through standardizing reprocessing of medical ultrasound probes,and formulating consensus recommendations with the Delphi method.The consensus clarifies the reprocessing principles for three types of ultrasound probes of different infection risks:external-use ul-trasound probes,interventional percutaneous ultrasound probes,and internal-use ultrasound probes,puts forward systematic suggestions on the reprocessing standards and disinfection levels of ultrasound probe isolation covers and coupling agents,the reprocessing procedures and methods of ultrasound probes,as well as architectural layout and management of reprocessing,so as to provide a scientific prevention and control framework for ensuring ultrasound diagnosis and therapy safety.

BACKGROUND:Percutaneous kyphoplasty assisted by C-arm under local anesthesia requires continuous adjustment of the puncture direction under multiple C-arm fluoroscopy.The establishment time of the working channel is longer,and the intraoperative pain stimulation of patients is larger.With the help of the robot,the puncture can be successfully performed at one time,which can significantly improve the experience of patients and reduce the risk of bone cement leakage.OBJECTIVE:To compare the patient experience and other outcomes of percutaneous kyphoplasty using robot-assisted and conventional C-arm fluoroscopy under local anesthesia.METHODS:A total of 241 patients with single-stage osteoporotic vertebral compression fracture were selected from Sichuan Academy of Medical Sciences·Sichuan Provincial People's Hospital(Affiliated Hospital,University of Electronic Science and Technology of China).132 patients underwent robot-assisted percutaneous kyphoplasty under local anesthesia(robot-assisted group).109 cases of conventional C-arm assisted percutaneous kyphoplasty under local anesthesia(conventional fluoroscopy group).Patients'intraoperative experience evaluation,bone cement injection amount,operation time,working channel establishment time,hospitalization cost and complications were recorded.Puncture deviation and bone cement leakage were evaluated by imaging on the first day after surgery.RESULTS AND CONCLUSION:(1)The intraoperative experience of 59 patients in the robot-assisted group was rated as"very good",43 as"good",16 as"average",10 as"poor",and 4 as"very poor,"while that of 30 patients in the conventional fluoroscopy group was rated as"very good",44 cases were"good",21"average",9"poor",and 5"very poor."There was a significant difference between the two groups in intraoperative experience evaluation(Z=-2.546,P=0.011).Intraoperative pain visual analog scale score was lower in the robot-assisted group than that in the conventional fluoroscopy group(t=-9.513,P=0.000).Totally 84 patients in the robot-assisted group and 47 patients in the conventional fluoroscopy group were willing to undergo percutaneous kyphoplasty again when necessary,and there was a significant difference between the two groups(Z=-2.730,P=0.006).(2)The operation time and hospitalization cost of the robot-assisted group were more than those of the conventional fluoroscopy group(t=2.860,P=0.003;t=36.522,P=0.000).The working channel establishment time of robot-assisted group was shorter than that of conventional fluoroscopy group(t=-27.066,P=0.000).The puncture deviation of robot-assisted group was better than that of conventional fluoroscopy group(Z=-3.656,P=0.000).The cement leakage of robot-assisted group was lower than that of conventional fluoroscopy group(χ2=7.284,P=0.007).(3)It is concluded that under local anesthesia,patients with robot-assisted percutaneous kyphoplasty have good surgical experience,with advantages of accurate puncture,short time to establish working channel,and low leakage rate of bone cement.

Objective To develop the Perceived Spouse Support Scale for pregnant women in the second and third trimester of pregnancy and test its reliability and validity,so as to provide an effective tool for assessing the perceived spouse support level of pregnant women.Methods With social support theory as the theoretical framework,the questionnaire item pool was initially constructed through literature review and semi-structured interview,and the initial questionnaire was formed through expert correspondence and cognitive interview.From April to November 2023,570 pregnant women in the second and third trimester of pregnancy were selected by random sampling method for investigation,item analysis and reliability and validity test of the scale.Results Eventually 558 pregnant women completed the suivey.The Perceived Spouse Support Scale for pregnant women in the second and third trimesters contained 22 items,including instrumental support,informational support and emotional support.The Cronbach's α coefficient of the scale was 0.867;the split-half reliability was 0.793;the retest reliability was 0.965;the content validity index was 0.980.The cumulative variance contribution rate of the 3 common factors was 54.138％.Confirmatory factor analysis suggested that the model fit well.Conclusion The Perceived Spouse Support Scale has good reliability and validity,and it can be used as an evaluation tool for spouse support level of pregnant women.