ObjectiveTo explore the incremental cost of central line-associated bloodstream infections （CLABSI） after central venous catheterization （CVC） in critically ill patients in the intensive care unit （ICU）， as well as the main cost of nosocomial infection prevention and control. By comparing these two costs， the medical personnel to pay more attention should CLABSI prevention and control from the perspectives of medical quality and economic benefits， and promote the implementation of prevention and control measures. MethodsCluster sampling was used to select 126 critically ill patients who underwent CVC in the ICU of a tertiary traditional Chinese medicine hospital from January 2021 to December 2023， including 65 cases in the CLABSI group and 61 in the non-CLABSI group. Patients’ data were retrospectively collected from the hospital medical records， including the disease type， gender， age， length of hospital stay， outcome， and hospitalization expenses. The costs of different hand hygiene methods and differing approaches to environmental cleaning and disinfection were analyzed and compared. ResultsThere were significant differences in the length of hospital stay （Z=-5.35， P<0.05） and total hospitalization expenses （Z=-6.79， P<0.05） between the CLABSI and non-CLABSI group. Total hospitalization expenses showed significant differences among patients with different lengths of hospital stay （H=43.01， P<0.05）， with much higher median one in those with 60 or more days of hospital stay than other patients. Greater differences of median total hospitalization expenses were found in males than in females （Z=-3.98， P<0.05）， as well as in patients aged 60-80 years than in patients of other ages （Z=-5.79， P<0.05）. ConclusionsThe occurrence of CLABSI significantly increases the ICU patients’ length of hospital stay and hospitalization expenses. There are differences in the costs of different hand hygiene methods and differing approaches to environmental cleaning and disinfection， but these costs are acceptable compared to the incremental costs directly attributable to CLABSI. Therefore， medical institutions should attach importance to the investment in prevention and control of nosocomial infections such as hand hygiene and environmental cleaning and disinfection， formulate practical， reasonable and feasible plans， and ensure their implementation， in order to avoid nosocomial infections， improve the medical quality， effectively control patients’ length of hospital stay and hospitalization costs， and strive to maintain patient safety.

Cornelia de Lange syndrome is a rare congenital malformation disease,and its typical features include growth restriction,mental retardation,craniofacial abnormality and hirsutism.This study reported 2 cases of CdLS patients,summarized their clinical manifestations and gene mutation characteristics,and the relevant literatures were reviewed.Patient 1,a 5-year-old girl,was admitted to the hospital due to growth retardation.Physical examination revealed hirsutism,monobrow,small and sparse teeth,hemangiomas(approximately 2 cm×2 cm)on the chest and back,delayed language development,and intellectual disability.The height was 98 cm[≤-2 standard deviation(SD)],the weight was 15 kg(-2SD--1SD),the head circumference was 46 cm(-3SD--2SD).Brain magnetic resonance imaging(MRI)plain scan showed slightly enlarged left lateral ventricle and bilateral lateral ventricle triangles,slightly thickened bilateral maxillary sinus and ethmoid sinus mucosa.Echocardiography revealed mild regurgitation of the mitral and tricuspid valves.Patient 2,a 1-month-old girl,was admitted to the hospital due to postpartum shortness of breath.The physical examination highlighted hirsutism,short nose,soft cleft palate,dysphagia,positive three-concave sign,audible throat sound,small hands,palm penetration in the left hand,short fifth finger of the right hand,limited right hip abduction,foot varus,and a white spot at the bottom of the right eye.Ultrasonography at 1 month showed mild regurgitation of the tricuspid valve and an open foramen ovale.Brain MRI at 2 d showed a few patchy low-signal shadows in the longitudinal fissure cistern and tentorium,a small amount of subarachnoid hemorrhage,and a small amount of fluid in the bilateral maxillary sinus,ethmoid sinus,and middle ear mastoid.No obvious structural or numerical abnormalities were observed in the chromosome karyotypes.Whole-exome sequencing detected a heterozygous variation of c.6653_6655del in the NIPBL gene in patient 1 and a heterozygous variation of c.337C＞T in the NIPBL gene in patient 2.These variations were not found in their parents.The study revealed that NIPBL gene variation could be the genetic cause of the two patients with CdLS.The identification of the variation c.337C＞T may expand the variation spectrum of the NIPBL gene,providing valuable insights into the pathogenic genetic basis of CdLS.

Objective To analyze the efficacy of CT-guided alcohol ablation of splanchnic nerve block(SNB)in the treatment of pain in patients with pancreatic cancer,and to discuss the related factors influencing the effectiveness in treating pancreatic cancer pain.Methods The clinical data of patients with pancreatic cancer pain,who was unable to receive surgery and underwent CT-guided SNB at Hai'an People's Hospital from June 2018 to September 2023,were retrospectively analyzed.According to postoperative one-month VAS pain score and the used dosage of opioids,the improvement of pain was assessed.Logistic regression analysis was used to evaluate the demographic characteristics,tumor features,and pain-related factors so as to determine the predictive factors for effective analgesia after SNB,and the survival outcomes were compared between the patients with effective SNB analgesia and the patients with ineffective SNB analgesia.Results A total of 133 patients were included in this analysis.One week after SNB,74.4％of patients achieved effective pain relief,and one month after the procedure,54.9％of patients experienced effective pain relief.One month after treatment,multivariate logistic regression analysis showed that the diabetes(OR=0.637,95％CI=0.397-0.876,P=0.034),serum CA199(OR=1.531,95％CI=1.030-2.370,P=0.042),serum MMP-1(OR=0.703,95％CI=0.457-0.983,P=0.038),preoperative ECOG score(OR=2.693,95％CI=1.234-6.609,P=0.021),and preoperative daily morphine consumption(OR=2.797,95％CI=1.148-6.695,P=0.019)were the independent predictive factors for achieving a good analgesic efficacy after SNB.Patients with poor analgesic outcomes after SNB had a significantly lower median survival time when compared to patients with good analgesic outcomes(82 days vs 149 days,P＜0.05).No serious SNB-related adverse events occurred.Conclusion For the treatment of refractory pancreatic cancer pain,CT-guided SNB is clinically safe and effective.The diabetes,ECOG score,serum MMP-1 level,CA199 level,and preoperative daily used dosage of opioids are the independent predictive factors for the efficacy of CT-guided SNB in treating pancreatic cancer pain.

Cancer cells refer to a group of malignant cells with strong division and proliferation abilities.Cancer cells rely on the unstable plunder of human nutrition to sustain the large amount of energy that they need for their own division and proliferation.The division and proliferation of cancer cells are linked to the synthesis and replication of genetic material in the nucleus.Blockage or destruction of the synthesis of genetic material in cancer cells is one of the mechanisms underlying the action of most antitumor drugs.As the key material that dominates cell division,proliferation,and death,nuclear genetic material which mainly refers to the deoxyribonucleic acid located on the chromatin in the nucleus,plays a decisive role in the final fate of cells.The final fate of cancer cells after the damage of the genetic material is worthy of investigation and analysis.In this paper,we discuss and analyze the fate of cancer cells after genetic material damage from the aspect of cellular cycle arrest,apoptosis,autophagy,and senescence to provide ideas for the mechanism research on antitumor drugs.

The emerging biomedical industry has an increasing demand for the professional talents and puts forward higher requirements for the quality, especially the innovation ability of the talents. Exploring a new model for fostering the innovation ability of postgraduates majoring in biological and medical sciences based on the principle of integrating production, education and research is of practical significance for improving the quality of professional talents and empowering the bio-economic development. Taking the training of innovation ability of postgraduates majoring in biological and medical sciences at Jiangnan University as an example, this paper introduced a new training system of "six integration and six optimizations". This system included ideological guidance, discipline system, training program, faculty, research innovation platform, and communication and cooperation. Satisfactory cultivation results were achieved with this new system. This paper is expected to provide reference for the training of innovative talents in the biological and medical industry.
Biological Science Disciplines/education* ; China ; Biomedical Research ; Humans ; Inventions

OBJECTIVE To study the improvement effects of Cannabis sativa oil on the symptoms in dextran sodium sulfate （DSS）-induced ulcerative colitis （UC） model rats， and to investigate its effects on intestinal flora of rats. METHODS Forty SD rats were randomly divided into control group， model group， C. sativa oil group （1 g/kg） and sulfasalazine group （positive control， 300 mg/kg）， with 10 rats in each group. The rats in control group and model group were given 0.5% polysorbate 80 by gavage， and the rats in C. sativa oil group and sulfasalazine group were given corresponding drug solution by gavage once a day for 10 days. From the 4th day， rats in model group， C. sativa oil group and sulfasalazine group were given 4% DSS solution for 7 consecutive days to establish UC model. The body weight， disease activity index （DAI） score， colon length， colon weight， weight per unit length of colon， the pathological changes of colon tissue， and the contents of tumour necrosis factor-α （TNF-α）， interleukin-6 （IL-6） and IL-10 in serum of rats were determined. The changes of intestinal flora in rats were detected by high- throughput sequencing. RESULTS Compared with control group， the body weight and the length of colon were decreased significantly in model group， while DAI score， the weight of colon， weight per unit length of colon， serum contents of TNF-α and IL-6 were increased significantly， and the content of IL-10 was decreased significantly （P＜0.05）； epithelial layer of colon tissue fell off， inflammatory cells infiltrated and invaded the submucosa， and intestinal glands were disordered. Compared with model group， above indexes of C. sativa oil group and sulfasalazine group were reversed significantly （P＜0.05）， and related symptoms were improved significantly. The result of flora sequencing showed that ACE index and Chao1 index of model group were decreased significantly， compared with control group （P＜0.05）； while Chao1 index of C. sativa oil group was increased significantly， compared with model group （P＜0.05）. Compared with control group， 41 genera of bacteria in the model group changed； compared with model group， C. sativa oil could return 3 of the 41 genera to normal state， including Dubosilla， Porphyrobacter and Allobaculum. CONCLUSIONS C. sativa oil can improve the symptoms of UC model rats by regulating the diversity of intestinal flora， increasing beneficial bacteria and decreasing pathogenic bacteria.

Objectives:To explore obesity prevalence and its association with dietary patterns among Tibetan pastoralists during the urbanization transition in Qinghai Province.Methods:Using an open cohort study design, 1 003 subjects were enrolled at baseline in 2018, 599 were followed up, and 1 012 were newly recruited in 2022. A total of 1 913 adults over 18 years were included in the study, and a questionnaire survey and health examination were conducted. Factor analysis was used to identify dietary patterns, and a mixed-effects model was used to analyze the association between dietary patterns and obesity.Results:From 2018 to 2022, the prevalence rates of overweight, obesity, and central obesity were 27.6%, 33.8%, and 54.6%, respectively. Age-sex-standardized prevalence of obesity and central obesity increased. Three dietary patterns were identified: the modern pattern was characterized by frequent consumption of pork, poultry, processed meat, fresh fruits, sugary drinks, salty snacks, etcetera; the urban pattern was characterized by frequent consumption of refined carbohydrates, beef and mutton, vegetables and eggs, etcetera; and pastoral pattern featured frequent consumption of tsamba, Tibetan cheese, buttered/milk tea, and whole-fat dairy products. After adjusting for demographic characteristics, socioeconomic status, and lifestyle factors, compared with the T1, subjects in the T3 of urban pattern scores were more likely to be overweight ( OR=2.09, 95% CI: 1.10-3.95) and overweight/obese ( OR=1.23, 95% CI: 1.00-1.51), whereas those in the T3 of pastoral pattern scores had a lower risk of overweight ( OR=0.45, 95% CI: 0.24-0.84), obesity ( OR=0.81, 95% CI: 0.69-0.95), overweight/obesity ( OR=0.75, 95% CI: 0.61-0.91) and central obesity ( OR=0.58, 95% CI: 0.38-0.89). Conclusions:Prevalence of obesity and central obesity was high among Tibetan pastoralists during the urbanization transition. Urban dietary pattern was a risk factor for overweight and overweight/obesity, whereas pastoral dietary pattern was a protective factor for overweight, obesity, overweight/obesity, and central obesity. Tailored interventions are needed to improve local people's health.

Objective:To construct a competency-oriented clinical practice teaching system for undergraduate anesthesia nursing students.Methods:From December 2022 to April 2023, based on the theory of job competency, a preliminary expert consultation questionnaire was drafted on the basis of literature analysis and semi-structured interviews. The Delphi method was used for two rounds of consultation with 21 experts in the field of anesthesia to establish the clinical practice teaching system for undergraduate anesthesia nursing students.Results:The effective recovery rates of the two rounds of consultation questionnaires were both 100.00% (21/21), and the authority coefficients of the experts were 0.877 and 0.895, respectively. The Kendall's harmony coefficients were between 0.138 to 0.227 and 0.165 to 0.283, respectively (both P<0.01). The final clinical practice teaching system for undergraduate anesthesia nursing students included four primary indicators, 11 secondary indicators, and 68 tertiary indicators. Conclusions:The clinical practice teaching system for undergraduate anesthesia nursing students, constructed based on job competency, is scientific and reliable. It has certain reference and guidance significance for the training of undergraduate anesthesia nursing students.

The vagina contains at least a billion microbial cells,dominated by lactobacilli.Here we perform metagenomic shotgun sequencing on cervical and fecal samples from a cohort of 516 Chinese women of reproductive age,as well as cervical,fecal,and salivary samples from a second cohort of 632 women.Factors such as pregnancy history,delivery history,cesarean section,and breastfeeding were all more important than menstrual cycle in shaping the microbiome,and such information would be necessary before trying to interpret differences between vagino-cervical micro-biome data.Greater proportion of Bifidobacterium breve was seen with older age at sexual debut.The relative abundance of lactobacilli especially Lactobacillus crispatus was negatively associated with pregnancy history.Potential markers for lack of menstrual regularity,heavy flow,dysmenor-rhea,and contraceptives were also identified.Lactobacilli were rare during breastfeeding or post-menopause.Other features such as mood fluctuations and facial speckles could potentially be predicted from the vagino-cervical microbiome.Gut and salivary microbiomes,plasma vitamins,metals,amino acids,and hormones showed associations with the vagino-cervical microbiome.Our results offer an unprecedented glimpse into the microbiota of the female reproductive tract and call for international collaborations to better understand its long-term health impact other than in the settings of infection or pre-term birth.

Objective:To construct an inservice training curriculum system for nurses in the Department of Anesthesiology based on core competence, so as to provide a reference for improving the core competence and standard training of anesthesia nurses.Methods:A research group was established in July 2020. Preliminary drafting of training curriculum system indicators and consultation questionnaires were made through the literature search and based on the content of the core competence evaluation index system of nurses in the Department of Anesthesiology. Convenience sampling was used to select 15 experts from August to October 2020, and the Delphi method was used to conduct two rounds of expert consultation. The content of the consultation included course content, training hours and training methods, which were used to construct an inservice training course system for nurses in the Department of Anesthesiology based on core competence.Results:The effective recovery rate of the two rounds of expert consultation was 100.00% (15/15), the expert authority coefficient was 0.864, and the Kendall coordination coefficient in the second round of consultation was 0.245. The inservice training course system for nurses in the Department of Anesthesiology was formed including 5 first-level indicators, namely, clinical nursing ability, critical thinking ability, communication and coordination ability, professional development ability, scientific literacy, 18 second-level indicators and 79 third-level indicators.Conclusions:The core competency-based inservice training course system for anesthesia nurses is scientific and practical, and can provide a reference for improving the core competence and standard training of anesthesia nurses.