OBJECTIVE To explore the risk factors for hospital-associated infections(HAI)in dead patients so as to provide bases for development of prevention strategies for the hospital-associated infections.METHODS Totally 560 patients who died due to non-SARS-CoV-2 infections and hospitalized in Gansu Provincial People's Hospital for more than 48 hours in 2019 and 2023 were retrospectively analyzed,70 of whom had HAI and were assigned as the HAI group,and the rest of 490 patients were assigned as the non-HAI group.The incidence of HAI,major causes of death,risk factors and economic burden were observed.RESULTS The incidence of HAI was 12.50％a-mong the dead patients,the lower respiratory tract infection was the predominant type of infection,and the re-spiratory failure was the primary and direct cause of death in the HAI group;the total treatment cost of the HAI group was higher than that of the non-HAI group(P＜0.05).Univariate analysis showed that there were signifi-cant differences in the length of hospital stay,multidrug-resistant organisms infections,combined use of antibiot-ics,surgery,hemodialysis/peritoneal dialysis,invasive procedures(drainage,puncture,intubation,tracheoto-my),use of equipment like ventilator or urinary catheter,central venous catheter indwelling,blood transfusion,and use of immunosuppressors/glucocorticoids between the HAI group and the non-HAI group(P＜0.05),while there were no significant differences in the sex,age,underlying diseases,modified early warning score(MEWS)and major diagnosis and chemoradiotherapy between the two groups.Multivariate analysis indicated that the length of hospital stay more than 14 days,history of surgery and combined use of antibiotics were the risk factors for HAI in the dead patients(P＜0.05).CONCLUSION It is necessary for the hospital to identify the high-risk pa-tients as early as possible,pay close attention to the lower respiratory tract infection,reduce the risk of HAI by shortening the length of hospital stay,standardizing the invasive procedures and reasonably using antibiotics so as to improve the prognosis of the patients.

OBJECTIVE To explore the risk factors for hospital-associated infections(HAI)in dead patients so as to provide bases for development of prevention strategies for the hospital-associated infections.METHODS Totally 560 patients who died due to non-SARS-CoV-2 infections and hospitalized in Gansu Provincial People's Hospital for more than 48 hours in 2019 and 2023 were retrospectively analyzed,70 of whom had HAI and were assigned as the HAI group,and the rest of 490 patients were assigned as the non-HAI group.The incidence of HAI,major causes of death,risk factors and economic burden were observed.RESULTS The incidence of HAI was 12.50％a-mong the dead patients,the lower respiratory tract infection was the predominant type of infection,and the re-spiratory failure was the primary and direct cause of death in the HAI group;the total treatment cost of the HAI group was higher than that of the non-HAI group(P＜0.05).Univariate analysis showed that there were signifi-cant differences in the length of hospital stay,multidrug-resistant organisms infections,combined use of antibiot-ics,surgery,hemodialysis/peritoneal dialysis,invasive procedures(drainage,puncture,intubation,tracheoto-my),use of equipment like ventilator or urinary catheter,central venous catheter indwelling,blood transfusion,and use of immunosuppressors/glucocorticoids between the HAI group and the non-HAI group(P＜0.05),while there were no significant differences in the sex,age,underlying diseases,modified early warning score(MEWS)and major diagnosis and chemoradiotherapy between the two groups.Multivariate analysis indicated that the length of hospital stay more than 14 days,history of surgery and combined use of antibiotics were the risk factors for HAI in the dead patients(P＜0.05).CONCLUSION It is necessary for the hospital to identify the high-risk pa-tients as early as possible,pay close attention to the lower respiratory tract infection,reduce the risk of HAI by shortening the length of hospital stay,standardizing the invasive procedures and reasonably using antibiotics so as to improve the prognosis of the patients.

[Objective]To summarize and analyze the research progress of flavonoids in the prevention and treatment of diabetes mellitus and its complications.[Methods]The role of flavonoids in diabetes mellitus and diabetic complications was summarized by searching the databases of Web of Science,PubMed,China National Knowledge Infrastructure,VIP,Wanfang and others for the reports of flavonoids and diabetes mellitus and diabetic complications from January 2013 to December 2022,and the role of flavonoids in diabetes mellitus and diabetic complications was summarized.[Results]Studies have confirmed that flavonoids(herbal flavonoid extracts,naringenin,galangal,kaempferol,etc.)are effective in preventing and treating diabetes and diabetes-induced retinopathy,nephropathy,cardiomyopathy,osteoporosis and diabetic foot.Overall regulation and comprehensive treatment are the characteristics of flavonoid components,which can inhibit inflammation,reduce oxidative stress,repair mitochondrial function,lower blood glucose,relieve insulin resistance and are able to influence the expression of related factors from multiple signaling pathways,thus treating diabetes and its complications.[Conclusion]The elaboration of the pharmacodynamic material basis,mechanism of action and constitutive relationship of Chinese medicine flavonoids against diabetes mellitus and its complications in multiple ways and at multiple levels are key issues to be solved in the development of flavonoids and an important direction for future research.

Zinc levels are high in pancreatic β-cells, and zinc is involved in the synthesis, processing and secretion of insulin in these cells. However, precisely how cellular zinc homeostasis is regulated in pancreatic β-cells is poorly understood. By screening the expression of 14 Slc39a metal importer family member genes, we found that the zinc transporter Slc39a5 is significantly down-regulated in pancreatic β-cells in diabetic db/db mice, obese ob/ob mice and high-fat diet-fed mice. Moreover, β-cell-specific Slc39a5 knockout mice have impaired insulin secretion. In addition, Slc39a5-deficient pancreatic islets have reduced glucose tolerance accompanied by reduced expression of Pgc-1α and its downstream target gene Glut2. The down-regulation of Glut2 in Slc39a5-deficient islets was rescued using agonists of Sirt1, Pgc-1α and Ppar-γ. At the mechanistic level, we found that Slc39a5-mediated zinc influx induces Glut2 expression via Sirt1-mediated Pgc-1α activation. These findings suggest that Slc39a5 may serve as a possible therapeutic target for diabetes-related conditions.

Professor Cai Wanru believes that in the stable phase of chronic obstructive pulmonary disease, "phlegm" and "stasis" are intertwined, with "phlegm" as the main component. Disease is manifested mostly in the lungs, spleen and kidney, and along with the duration of the disease, the patients are prone to "sputum", "stasis" and other pathological products, so that acute aggravating symptoms are often induced due to the transformation from "phlegm" to "stasis". The clinical manifestations are mainly the lack of righteousness, and various symptoms due to phlegm stagnation and blood stasis. Therefore, Professor Cai believes that the thought of "preventive treatment of disease" should be throughout the treatment of the disease. The thought is based on the principle of the relationships between the five internal organs. According to the characteristics of disease transmission, combined with the syndrome differentiation of physical constitution, the importance of strengthening the body resistance and nourishing the vigour was emphasized. In terms of the methods of treatment, methods such as nourishing the lungs and tonifying the spleen, warming the kidney and tonifying qi are often applied, so the prescription is flexible and the compatibility is rigorous. In terms of the control of symptoms and prevention of acute exacerbations, it has a significant effect. Therefore, the thought of "preventive treatment of disease" proposed by Professor Cai Wanru has a practical value in the clinical treatment of chronic obstructive pulmonary disease, which is worthy of promotion.

Objective] To research professor Cai’s experience in treating stable chronic obstructive pulmonary disease(COPD). [Method] The paper expounds Professor Cai’s experience in treating stable chronic obstructive pulmonary disease by analyzing the etiology, pathology, summarizing the clinical thoughts and citing the typical case. [Result] Professor Cai emphasized therapies of strengthening body resistance,replenishing Qi,treating zang and fu together,activating blood,dredging collaterals, treating disease with the theory of Chinese medicine and modern medicine as well as applying the theory of preventive treatment of disease on preventing the exacerbation of COPD. Better clinical effects were acquired. [Conclusion] Professor Cai Wanru always grabs for the treatment of qi deficiency and phlegm, blood stasis of the disease.She is good at prescribing formula. Therefore the treating method has clinical value.