ObjectiveTo investigate the current professional competency among full-time and part-time personnel of the nosocomial infection control administration in Shanghai, so as to provide a scientific basis for future training programmes. MethodsIn December 2024, a questionnaire survey was conducted by the Shanghai Nosocomial Infection Quality Control Center among full-time and part-time personnel of the nosocomial infection control administration across medical institutions at various levels and types in Shanghai using convenience sampling method. The questionnaire consisted of two parts: demographic information and professional competency assessment. The professional competency scale comprised four dimensions: fundamental cognition, basic skills, professional expertise, and personal qualities, totaling 35 items. ResultsA total of 1 179 questionnaires were distributed, with 1 144 valid responses collected, yielding an effective response rate of 97.03%. Statistically significant differences were observed among full-time and part-time personnel of the nosocomial infection control administration in terms of age (t=5.32, P=0.021), professional background (χ²=9.90, P=0.019), educational qualifications (χ²=19.10, P<0.001), professional titles (χ²=12.60, P=0.002), and the levels of medical institutions (χ²=111.08, P<0.001). The scores of full-time personnel of the nosocomial infection control administration in fundamental cognition [92 (82, 99) points] and basic skills [88 (78, 96) points] were significantly higher than those of part-time personnel(Z=-2.21, P=0.027;Z=-2.74, P=0.006). Statistically significant differences were found in fundamental cognition scores between full-time and part-time personnel of the nosocomial infection control administration regarding occupational safety protection, definition of healthcare-associated infection outbreaks, types of drug-resistant bacteria and their prevention and control strategies, and transmission routes of different infectious diseases (all P<0.05). Statistically significant differences were also observed in basic skills scores including proficient use of monitoring platforms, formulation and revision of standard operating procedures (SOPs), independent completion of targeted surveillance, guidance on basic infection control skills, guidance for key departments, and follow-up of personnel with occupational exposure (all P<0.05). However, no statistically significant differences were found in scores of professional knowledge and personal qualities (P>0.05). ConclusionThere are certain differences in professional competency between full-time and part-time personnel of the nosocomial infection control administration in Shanghai in terms of fundamental cognition and basic skills. Part-time personnel can effectively improve their professional competency through systematic training on basic infection control knowledge and practical skills, thereby comprehensively enhancing the overall quality of the nosocomial infection administration team.

OBJECTIVE To screen and quantitatively analyze the quality marker （Q-Marker） associated with anti-renal fibrosis in Shenqi shenshuai mixture （SQSS）， so as to provide references for the analysis of pharmacodynamic substances and new drug transformation of SQSS. METHODS The chemical components of SQSS were characterized by untargeted metabolomics. Combined with network pharmacology， gene expression omnibus （GEO） and connectivity map （CMAP） databases， the anti-renal fibrosis Q-Markers of SQSS were screened. HPLC-MS/MS was applied to determine the contents of Q-Markers in 10 batches of SQSS. RESULTS A total of 1 319 compounds were identified from SQSS via untargeted metabolomics，and 84 active ingredients with anti-renal fibrosis activity were further screened out， such as formononetin. Nine anti-renal fibrosis Q-Markers were obtained by network pharmacology and GEO database， including berberine， quercetin， honokiol， nicotinamide， daidzein， coumarin， kaempferol， formononetin and amygdalin. The quantitative results showed that the average contents of the above components （excluding amygdalin） in 10 batches of SQSS were 2.523， 1.942， 26.848， 1.415， 0.692， 0.171， 0.374， 7.401 μg/mL， respectively. CONCLUSIONS Nine anti-renal fibrosis Q-Markers of SQSS were screened in this study， and the contents of eight among them were determined. The results can provide a basis for elucidating the pharmacodynamic material basis and promoting the new drug transformation of SQSS.

OBJECTIVE To screen and quantitatively analyze the quality marker （Q-Marker） associated with anti-renal fibrosis in Shenqi shenshuai mixture （SQSS）， so as to provide references for the analysis of pharmacodynamic substances and new drug transformation of SQSS. METHODS The chemical components of SQSS were characterized by untargeted metabolomics. Combined with network pharmacology， gene expression omnibus （GEO） and connectivity map （CMAP） databases， the anti-renal fibrosis Q-Markers of SQSS were screened. HPLC-MS/MS was applied to determine the contents of Q-Markers in 10 batches of SQSS. RESULTS A total of 1 319 compounds were identified from SQSS via untargeted metabolomics，and 84 active ingredients with anti-renal fibrosis activity were further screened out， such as formononetin. Nine anti-renal fibrosis Q-Markers were obtained by network pharmacology and GEO database， including berberine， quercetin， honokiol， nicotinamide， daidzein， coumarin， kaempferol， formononetin and amygdalin. The quantitative results showed that the average contents of the above components （excluding amygdalin） in 10 batches of SQSS were 2.523， 1.942， 26.848， 1.415， 0.692， 0.171， 0.374， 7.401 μg/mL， respectively. CONCLUSIONS Nine anti-renal fibrosis Q-Markers of SQSS were screened in this study， and the contents of eight among them were determined. The results can provide a basis for elucidating the pharmacodynamic material basis and promoting the new drug transformation of SQSS.

OBJECTIVE To investigate the current status of bloodborne occupational exposures among healthcare workers in a three-A specialized hospital of Shanghai so as to provide bases for formulating prevention measures for occupational exposures.METHODS A questionnaires titled'Survey of bloodborne occupational exposures among healthcare workers'were clinically distributed to Eye &ENT Hospital of Fudan University through'Wenjuanxing platform'from Feb.2024 to Apr.2024.The content of the questionnaire included four parts:the baseline data questionnaire,incidence of occupational exposures,awareness of knowledge about occupational exposures,and preventive behaviors regarding occupational exposures.RESULTS A total of 995 valid questionnaires were collect-ed in the survey,the result of the survey showed that the incidence of bloodborne occupational exposures was 10.65％.The clinicians and doctors engaging in advanced studies were at high risk of the occupational exposures especially when they were busy with work.The result of the survey indicated that the rate of missing report was 71.33％,the implementation rate of monitoring was only 48.11％after the exposures,of which the major cau-ses included the health care workers'insufficient attention to the exposure events,flaws in prevention and control of occupational exposures and some personnels'poor awareness of reporting process and requirements for monito-ring.Although the awareness rate of emergency processing exceeded 90％,the awareness rate of the knowledge a-bout prophylactic use of antibiotics and prevention of needlestick injuries,and the preparations before diagnosis and treatment,standardized operations and use of protective articles still needed to be improved.CONCLUSIONS The survey reveals that the health care workers pay less attention to the risk of infections,and the prevention of occupational exposure needs to be improved.It is of great importance to raise the awareness of prevention and en-hance the systematic training for occupational exposure.

OBJECTIVE To investigate the current status of contamination with carbapenem-resistant gram-negative bacteria in environment of intensive care units(ICU)of tertiary hospitals in Shanghai and find out the potential contamination sources so as to provide bases for prevention and control of multidrug-resistant organisms infec-tions in the ICUs.METHODS The surroundings of the ICU patients detected with CRGNB and environmental ob-jects surfaces in public area were sampled by mSuperCARBA chromogenic media from Dec.2024 to Jan.2025,the strains were isolated,and the targeted strains were identified by matrix-assisted laser desorption/ionization time-of-flight(MALDI-TOF)mass spectrometer.RESULTS A total of 653 samples were collected in the survey,76 of which were positive for bacterial culture,60 were detected with CRGNB,and the isolation rate of CRGNB was 9.19％.The isolation rate of CRGNB was 53.40％in the water-source group,0.91％in the non-water-source group,and there was significant difference(x2=286.450,P＜0.001).The result of whole genome sequencing for 17 strains of CRKP showed that ST11 and ST15 were the two major types of multilocus typing(MT),respective-ly carrying 2-12 types of drug resistance genes.CONCLUSIONS The CRGNB strains are detected in some environ-mental sites of the ICUs of 15 tertiary hospitals in Shanghai,and the isolation rate of CRKP is highest among them.The colonization rate of CRGNB is relatively low on the highly frequent-contact object surfaces of the ICUs,however,sink drain holes poses a risk of hospital-acquired CRGNB infections transmissions.Additionally,the ba-sins and towels of the CRGNB patients are hard to be thoroughly cleaned,disinfected and dried,resulting in a high contamination rate.

OBJECTIVE To investigate the use of common disposable and reusable supplies for prevention and con-trol of infections in Shanghai.METHODS A survey was conducted for the use and reuse of disposable high-value consumables,disposable bronchoscopes and environmental cleaning and disinfection tools in Shanghai by using structured questionnaire.RESULTS Totally 81 medical institutions were involved in the survey,44(54.32％)of which were tertiary hospitals,and the median number of beds was 500.The orthopedic implants(70.37％),ul-trasound knife(69.14％)and endoscopic puncture instrument(66.67％)were the high-value consumables rank-ing the top 3 utilization rates.There was reuse of 18 types of high-value consumables in total among the 12 medi-cal institutions.The major causes of reuse of high-value consumables included fee less tan cost of consumables(58.33％)or being unable to included in charge items(33.33％).27.78％of the recycle high-value consumables were not treated with a dedicated disinfection and sterilization system and procedures for the disposable high-value consumables,and 33.33％did not have the report systems for related adverse reactions.49.09％of the medi-cal institutions reported to use the disposable bronchoscopes,4 of which reused them.The majority of the medi-cal institutions could carry out centralized cleaning and disinfection for the recycled floor cloths(60.81％)and cloth towels(56.76％),and 32.43％of the medical institutions reused the cloth towels by manual cleaning.The utilization rate of antiseptic wipes was 75.41％in adult intensive care unit,62.50％in neonatal intensive care unit.CONCLUSION The study reveals that there are some problems in the use of disposal and reusable supplies for prevention and control of infections,which may provide baseline data for management of the related supplies and the surveillance of disinfection of the recycled supplies so as to enhance the quality of management of hospital-asso-ciated infections.

The lumbar intervertebral disc exhibits a complex physiological structure with interactions between various segments, and its components are extremely complex. The material properties of different components in the lumbar intervertebral disc, especially the water content (undergoing dynamic change as influenced by age, degeneration, mechanical loading, and proteoglycan content) - critically determine its mechanical properties. When the lumbar intervertebral disc is under continuous pressure, water seeps out, and after the pressure is removed, water re-infiltrates. This dynamic fluid exchange process directly affects the mechanical properties of the lumbar intervertebral disc, while previous isotropic modeling methods have been unable to accurately reflect such solid-liquid phase behaviors. To explore the load-bearing mechanism of the lumbar intervertebral disc and establish a more realistic mechanical model of the lumbar intervertebral disc, this study developed a solid-liquid biphasic, fiber-reinforced finite element model. This model was used to simulate the four movements of the human lumbar spine in daily life, namely flexion, extension, axial rotation, and lateral bending. The fluid pressure, effective solid stress, and liquid pressure-bearing ratio of the annulus fibrosus and nucleus pulposus of different lumbar intervertebral discs were compared and analyzed under the movements. Under all the movements, the fluid pressure distribution was closer to the nucleus pulposus, while the effective solid stress distribution was more concentrated in the outer annulus fibrosus. In terms of fluid pressure, the maximum fluid pressure of the lumbar intervertebral disc during lateral bending was 1.95 MPa, significantly higher than the maximum fluid pressure under other movements. Meanwhile, the maximum effective solid stress of the lumbar intervertebral disc during flexion was 2.43 MPa, markedly higher than the maximum effective solid stress under other movements. Overall, the liquid pressure-bearing ratio under axial rotation was smaller than that under other movements. Based on the solid-liquid biphasic modeling method, this study more accurately revealed the dominant role of the liquid phase in the daily load-bearing process of the lumbar intervertebral disc and the solid-phase mechanical mechanism of the annulus fibrosus load-bearing, and more effectively predicted the solid-liquid phase co-load-bearing mechanism of the lumbar intervertebral disc in daily life.
Humans ; Finite Element Analysis ; Intervertebral Disc/physiology* ; Lumbar Vertebrae/physiology* ; Weight-Bearing/physiology* ; Biomechanical Phenomena ; Stress, Mechanical ; Computer Simulation ; Models, Biological

Objective To evaluate the predictive value of triglyceride-glucose body mass index(TyG-BMI),atherogenic index of plasma(AIP),and postprandial glucose excursion(PPGE)for sarcopenia in patients with type 2 diabetes mellitus(T2DM).Methods An observational cohort trial was conducted on 590 hospitalized T2DM patients(322 males and 268 females)admitted to Department of Endocrinology of the First Affiliated Hospital of Chongqing Medical University between January 2023 and December 2024.General demographic data and key metabolic indicators,including fasting plasma glucose(FPG),postprandial 2-hour plasma glucose(PPG),triglyceride(TG)were collected,and then TyG-BMI,AIP,and PPGE were calculated.Based on the Asian Working Group for Sarcopenia(AWGS)2019 criteria,they were divided into a sarcopenia group(n=140)and a non-sarcopenia group(n=450).After 1∶1 propensity score matching(PSM),102 patients with sarcopenia were matched with 102 without.Differences in metabolic indicators FPG,PPG,TyG-BMI,AIP and PPGE were compared between the 2 groups.Spearman correlation analysis was conducted to assess correlations of these indicators with sarcopenia.Conditional logistic regression analysis was performed to identify independent risk factors,and receiver operating characteristic(ROC)curves were plotted to assess predictive performance.An external validation cohort consisting of 192 T2DM patients from Department of Endocrinology of Jiangbei Branch of First Affiliated Hospital of Army Medical University between January 2023 and December 2024 was included to validate the prediction model.Results After PSM,the baseline data of the 2 groups was balanced(P>0.05).The sarcopenia group showed higher levels of PPG,AIP,and PPGE,but lower TyG-BMI value than the non-sarcopenia group(all P=0.001).Spearman correlation analysis revealed that the TyG-BMI was negatively correlated(r=-0.404,P=0.001),whereas AIP and PPGE were positively correlated with concomitant sarcopenia(r=0.280,P=0.001;r=0.372,P=0.001)in the T2DM patients.Conditional logistic regression analysis identified AIP(OR=14.367)and PPGE(OR=1.245)as independent risk factors,while TyG-BMI(OR=0.966)as independent protective factors.ROC curve analysis revealed that the area under the curve(AUC)of the combined model of TyG-BMI,AIP and PPGE in predicting sarcopenia was 0.918,and the AUC value was 0.954 in external validation,with good sensitivity and specificity.Conclusion TyG-BMI,AIP,and PPGE are important metabolic predictors in T2DM patients with sarcopenia.Their combination has good screening value for sarcopenia,and can be applied in external prediction for T2DM patients.

Objective To explore the disinfection effect of periodic hypochlorous acid infusion on water supply pipelines.Methods Water specimens from 6 water outlets of central sterile supply department were collected at baseline for microbial culture.After introducing a slightly acidic hypochlorous acid water generator,water speci-mens were collected every 10 days.Continuous disinfection with hypochlorous acid was carried out on the 1st-3rd day,and discontinued on the 4th-10th day.Water specimens of 6 water outlets were collected on the 1st,4th,7th,and 10th day of each cycle,in total 3 cycles.Microbial culture and metagenomic next-generation sequencing(mNGS)analysis were conducted simultaneously on all water specimens from the outlets of the endoscope cleaning tank.Results Before disinfection of the pipeline,a total of 18 bottles of water specimens were collected.Bacterial count of water specimens from 10 bottles(55.56％)was between 102 and 104 CFU/mL,mainly Sphingomonas ad-hesins and Bacillus cereus.After disinfection,only 2 out of 72 water specimens(2.78％)exceeded the bacterial lim-it.The mNGS results showed that three most dominant bacterial genera in the pre-disinfection water specimens were Sphingomonas,Methylobacterium,and Ralstonia,with stringent mapped reads number(SMRN)ranging from 10 000 to 100 000;while the most dominant bacterial genera in post-disinfection water specimens were Lacto-baci-llus,Ralstonia,Acinetobacter,and Bradyrhizobium.PCoA analysis showed that there was a statistically sig-nificant difference in β-diversity of water specimens before and after disinfection(P＜0.05).Conclusion Periodic hypochlorous acid infusion disinfection can effectively remove bacterial biofilms in water pipelines,but there is a risk of bacterial biofilm recovery during disinfection suspension.In the future,monitoring and management of medical water should be strengthened.

Objective:To study the effect of traditional Chinese medicine (TCM) formula in the treatment of brucellosis.Methods:Patients with brucellosis who were treated at the Beidahuang Industry Group General Hospital from March to November 2024 were selected and their clinical data were collected. A case-control study was conducted, thirty patients treated with conventional therapy plus TCM formula were selected as the TCM group, and 35 patients treated with conventional therapy were selected as the control group. Blood routine, C-reactive protein (CRP), lymphocyte subsets (CD45 +, CD3 +, CD4 +, CD8 +, CD19 +), and related cytokines [interleukin (IL)-6, IL-10] were determined before and after treatment to observe the clinical effect of TCM formula in the treatment of brucellosis. Survival curve was draw, and Log-Rank test was used to compare the differences in clinical symptom relief time between the two groups of patients. Results:Compared with pre-treatment, there were statistically significant differences in the numbers of CD45 +, CD3 +, CD4 +, CD8 +, CD19 + lymphocytes, neutrophil (NEUT), and the levels of CRP, IL-6, and IL-10 in the TCM group after treatment ( P < 0.05). After treatment, the comparison of each index between the two groups showed that there were statistically significant differences in the numbers of CD45 +, CD3 +, CD4 +, and CD8 + lymphocytes [control group vs TCM group: 2 470.00 (1 895.50, 3 207.00) vs 1 991.00 (1 720.75, 2 367.25), 1 920.00 (1 364.50, 2 428.00) vs 1 591.00 (1 343.00, 1 884.00), 1 021.00 (785.00, 1 205.50) vs 839.50 (704.25, 1 010.25), (686.42 ± 294.47) vs (596.97 ± 205.32) pieces/μl, P < 0.05]. There was no statistically significant difference in the number of CD19 + lymphocytes, NEUT, and the levels of CRP, IL-6 and IL-10 ( P > 0.05). The Log-Rank test results showed that there were statistically significant differences in the relief time of hyperhidrosis and night sweats ( P = 0.016), fatigue ( P = 0.016), and muscle soreness ( P = 0.004) between the two groups of patients. Conclusion:TCM formula has certain effects in the adjuvant therapy of brucellosis, which can improve the immune function of lymphocytes and relieve clinical symptoms, and has clinical application value.