OBJECTIVE: Blood culture remains the gold standard for diagnosing bloodstream infections. Clinical laboratories must ensure the quality of blood culture processes from receipt to obtaining definitive results. We examined laboratory analytical indicators associated with positive blood culture results. METHODS: Blood cultures collected from Peking Union Medical College Hospital between January 1, 2020, and December 31, 2022, were retrospectively analyzed. The mode of transportation (piping logistics delivery vs. staff), source of blood cultures (outpatient/emergency department vs. inpatient department), rotation of personnel, and time of reception (8:00-19:59 vs. 20:00-07:59) were compared between blood culture-positive and -negative results. RESULTS: Between 2020 and 2022, the total positive rate of blood culture was 8.07%. The positive rate of blood cultures in the outpatient/emergency department was significantly higher than that in the inpatient department (12.46% vs. 5.83%; P < 0.0001). The time-to-detection of blood cultures was significantly affected by the delivery mode and personnel rotation. The blood culture positive rate of the total pre-analytical time within 1 h was significantly higher than that within 1-2 h or > 2 h ( P < 0.0170). CONCLUSION Laboratory analytical indicators such as patient source, transportation mode, and personnel rotation significantly impacted the positive detection rate or time of blood culture.
Blood Culture/statistics & numerical data* ; Humans ; Retrospective Studies ; Emergency Service, Hospital/statistics & numerical data*

Aim To explore the mechanism by which the compound Chaijin Jieyu formula(CCJJY)regulates the TLR4/NLRP3 signaling pathway to inhibit central oxidative stress and improve hippocampal synaptic plasticity damage in depression.Methods SD rats were randomly divided into the control group,chronic unpredictable mild stress group,sleep deprivation group,chronic unpredictable mild stress combined with sleep deprivation group,positive drug group(venlafax-ine+melatonin),low-dose group of CCJJY,medium dose group of CCJJY,and high-dose group of CCJJY,with nine rats in each group.Except for the control group,a rat model of depression complicated with in-somnia was established using chronic unpredictable mild stress combined with sleep deprivation.Depres-sion-like and sleep behaviors in rats were evaluated through weight,food intake,water maze,and pento-barbital sodium tests.ELisa was used to detect ROS,AANAT,and HPLC-EC was used to detect 5-HT con-tent,while Western blot/RT-PCR was used to detect the expression of IL-1β,TLR4,NLRP3,PSD-95,and SYN related proteins and mRNA.HE and Golgic stai-ning were used to observe the pathological changes in the third ventricle,hippocampus,and neuronal synap-ses.Results Compared with the control group,the depression-like behaviors of the model group rats were significant.The expression of IL-1β,TLR4,and NL-RP3 in the hippocampus increased,while the expres-sion of PSD-95 and SYN decreased.Activation of NL-RP3 inflammasomes led to "sleeve like" pathological changes in the third ventricle,with hippocampal neu-rons undergoing apoptosis and significant damage to neuronal synaptic plasticity.Compared with the model group,after intervention with CCJJY,the expression of ROS,IL-1β,TLR4,and NLRP3 decreased,while the expression of AANAT,5-HT,PSD-95,and SYN in-creased.Pathological damage to the third ventricle and hippocampal neurons was repaired.Conclusion The CCJJY improves hippocampal synaptic plasticity dam-age in depression by regulating the TLR4/NLRP3 sig-naling pathway to inhibit central oxidative stress.

Immobilized enzyme-based enzyme electrode biosensors, characterized by high sensitivity and efficiency, strong specificity, and compact size, demonstrate broad application prospects in life science research, disease diagnosis and monitoring, etc. Immobilization of enzyme is a critical step in determining the performance (stability, sensitivity, and reproducibility) of the biosensors. Random immobilization (physical adsorption, covalent cross-linking, etc.) can easily bring about problems, such as decreased enzyme activity and relatively unstable immobilization. Whereas, directional immobilization utilizing amino acid residue mutation, affinity peptide fusion, or nucleotide-specific binding to restrict the orientation of the enzymes provides new possibilities to solve the problems caused by random immobilization. In this paper, the principles, advantages and disadvantages and the application progress of enzyme electrode biosensors of different directional immobilization strategies for enzyme molecular sensing elements by specific amino acids (lysine, histidine, cysteine, unnatural amino acid) with functional groups introduced based on site-specific mutation, affinity peptides (gold binding peptides, carbon binding peptides, carbohydrate binding domains) fused through genetic engineering, and specific binding between nucleotides and target enzymes (proteins) were reviewed, and the application fields, advantages and limitations of various immobilized enzyme interface characterization techniques were discussed, hoping to provide theoretical and technical guidance for the creation of high-performance enzyme sensing elements and the manufacture of enzyme electrode sensors.

Objective:To evaluate the lung ultrasound characteristics of mycoplasma pneumoniae pneumonia in children and to investigate the value of lung ultrasound monitoring in clinical diagnosis and treatment.Methods:A retrospective analysis of 62 children with mycoplasma pneumoniae pneumonia admitted to Xi'an Chest Hospital from 7 November to 30 November 2023 was performed，and the characteristic parameters of bedside lung ultrasound and their related clinical data were collected. Pathological lung ultrasound features such as interrupted pleural line，well-spaced B-lines，coalescent B-lines，small subpleural patchy pulmonary consolidation，large pulmonary consolidation and pleural effusion in 12 scan areas of both lungs were observed. The maximum upper and lower diameters，right and left diameters，and anterior and posterior diameters of the large pulmonary consolidations were measured，and the changes in the above signs before and after treatment were measured and compared.Results:In sixty-two children with mycoplasma pneumoniae pneumonia，including 32 males and 30 females，with a mean age of（8.18 ± 2.05）years old and a mean hospital stay of（8.79 ± 2.93）days，lung ultrasound showed interrupted pleural line，well-spaced B-lines，coalescent B-lines，small subpleural patchy pulmonary consolidation，large pulmonary consolidation and pleural effusion，with the incidence of 93.5%（58 /62），33.9%（21/62），32.3%（20/62），59.7%（37/62），66.1%（41/62）and 17.7%（11/62），respectively，in which the large pulmonary consolidations presented rich blood supply were more common in the L6 and L4 areas，while the pleural effusions were more common in the L6 area.The signs of interrupted pleural line，coalescent B-lines，large pulmonary consolidation and pleural effusion were significantly improved after treatment compared with before treatment（all P<0.05）. The upper and lower diameters，left and right diameters，and anterior and posterior diameters of large pulmonary consolidations were significantly reduced after treatment compared with before treatment［（4.19 ± 2.42）cm vs.（2.84 ± 2.31）cm， t=2.613， P=0.011；（2.80 ± 1.82）cm vs.（1.96 ± 1.62）cm， t=2.226， P=0.029；（3.41 ± 2.11）cm vs.（2.12 ± 1.82）cm， t=2.972， P=0.004］.With the process of treatment，the dynamic observation of lung ultrasound showed that the well-spaced B-lines/coalescent B-lines gradually decreased until they completely disappeared or a small number of B-lines remained，and the area of the large pulmonary consolidation showed a dynamic downward trend（all P<0.001），and the area of large pulmonary consolidations gradually decreased until they completely disappeared or only small subpleural patchy pulmonary consolidations and well-spaced/coalescent B-lines remained，and at the same time，the pleural effusion gradually absorbed until it disappeared. Conclusions:Lung ultrasound can detect the distribution area of lung lesions，morphology and blood supply characteristics of children with mycoplasma pneumoniae pneumonia，as well as the dynamic changes after treatment，and lung ultrasound can dynamically monitor and evaluate the progression and regression of the disease in real time，providing a reliable imaging evidence for clinical practice.

Aim To explore the mechanism by which the compound Chaijin Jieyu formula(CCJJY)regulates the TLR4/NLRP3 signaling pathway to inhibit central oxidative stress and improve hippocampal synaptic plasticity damage in depression.Methods SD rats were randomly divided into the control group,chronic unpredictable mild stress group,sleep deprivation group,chronic unpredictable mild stress combined with sleep deprivation group,positive drug group(venlafax-ine+melatonin),low-dose group of CCJJY,medium dose group of CCJJY,and high-dose group of CCJJY,with nine rats in each group.Except for the control group,a rat model of depression complicated with in-somnia was established using chronic unpredictable mild stress combined with sleep deprivation.Depres-sion-like and sleep behaviors in rats were evaluated through weight,food intake,water maze,and pento-barbital sodium tests.ELisa was used to detect ROS,AANAT,and HPLC-EC was used to detect 5-HT con-tent,while Western blot/RT-PCR was used to detect the expression of IL-1β,TLR4,NLRP3,PSD-95,and SYN related proteins and mRNA.HE and Golgic stai-ning were used to observe the pathological changes in the third ventricle,hippocampus,and neuronal synap-ses.Results Compared with the control group,the depression-like behaviors of the model group rats were significant.The expression of IL-1β,TLR4,and NL-RP3 in the hippocampus increased,while the expres-sion of PSD-95 and SYN decreased.Activation of NL-RP3 inflammasomes led to "sleeve like" pathological changes in the third ventricle,with hippocampal neu-rons undergoing apoptosis and significant damage to neuronal synaptic plasticity.Compared with the model group,after intervention with CCJJY,the expression of ROS,IL-1β,TLR4,and NLRP3 decreased,while the expression of AANAT,5-HT,PSD-95,and SYN in-creased.Pathological damage to the third ventricle and hippocampal neurons was repaired.Conclusion The CCJJY improves hippocampal synaptic plasticity dam-age in depression by regulating the TLR4/NLRP3 sig-naling pathway to inhibit central oxidative stress.

Objective:To evaluate the lung ultrasound characteristics of mycoplasma pneumoniae pneumonia in children and to investigate the value of lung ultrasound monitoring in clinical diagnosis and treatment.Methods:A retrospective analysis of 62 children with mycoplasma pneumoniae pneumonia admitted to Xi'an Chest Hospital from 7 November to 30 November 2023 was performed，and the characteristic parameters of bedside lung ultrasound and their related clinical data were collected. Pathological lung ultrasound features such as interrupted pleural line，well-spaced B-lines，coalescent B-lines，small subpleural patchy pulmonary consolidation，large pulmonary consolidation and pleural effusion in 12 scan areas of both lungs were observed. The maximum upper and lower diameters，right and left diameters，and anterior and posterior diameters of the large pulmonary consolidations were measured，and the changes in the above signs before and after treatment were measured and compared.Results:In sixty-two children with mycoplasma pneumoniae pneumonia，including 32 males and 30 females，with a mean age of（8.18 ± 2.05）years old and a mean hospital stay of（8.79 ± 2.93）days，lung ultrasound showed interrupted pleural line，well-spaced B-lines，coalescent B-lines，small subpleural patchy pulmonary consolidation，large pulmonary consolidation and pleural effusion，with the incidence of 93.5%（58 /62），33.9%（21/62），32.3%（20/62），59.7%（37/62），66.1%（41/62）and 17.7%（11/62），respectively，in which the large pulmonary consolidations presented rich blood supply were more common in the L6 and L4 areas，while the pleural effusions were more common in the L6 area.The signs of interrupted pleural line，coalescent B-lines，large pulmonary consolidation and pleural effusion were significantly improved after treatment compared with before treatment（all P<0.05）. The upper and lower diameters，left and right diameters，and anterior and posterior diameters of large pulmonary consolidations were significantly reduced after treatment compared with before treatment［（4.19 ± 2.42）cm vs.（2.84 ± 2.31）cm， t=2.613， P=0.011；（2.80 ± 1.82）cm vs.（1.96 ± 1.62）cm， t=2.226， P=0.029；（3.41 ± 2.11）cm vs.（2.12 ± 1.82）cm， t=2.972， P=0.004］.With the process of treatment，the dynamic observation of lung ultrasound showed that the well-spaced B-lines/coalescent B-lines gradually decreased until they completely disappeared or a small number of B-lines remained，and the area of the large pulmonary consolidation showed a dynamic downward trend（all P<0.001），and the area of large pulmonary consolidations gradually decreased until they completely disappeared or only small subpleural patchy pulmonary consolidations and well-spaced/coalescent B-lines remained，and at the same time，the pleural effusion gradually absorbed until it disappeared. Conclusions:Lung ultrasound can detect the distribution area of lung lesions，morphology and blood supply characteristics of children with mycoplasma pneumoniae pneumonia，as well as the dynamic changes after treatment，and lung ultrasound can dynamically monitor and evaluate the progression and regression of the disease in real time，providing a reliable imaging evidence for clinical practice.

Sesquiterpenoids are widely found in nature, while nitrobenzoyl sesquiterpenoids are relatively rare. Twelve natural nitrobenzoyl sesquiterpenoids were all derived from marine Aspergillus fungi, which are typical natural products with marine characteristics. These natural products exhibit good antitumor, antiviral, and inhibition of osteoclast differentiation activity, especially in the treatment of osteoclast-related diseases, showing good medicinal development value. This article reviews the natural product sources, chemical structure, chemical synthesis, biosynthesis, bioactivity, and pharmacological mechanisms of nitrobenzoyl sesquiterpenoids and predicts and discusses their absorption, distribution, metabolism, excretion, toxicity (ADME/T), and drug-likeness, providing a comprehensive understanding of the natural products of nitrobenzoyl sesquiterpenoids from marine sources and their potential for pharmaceutical development.

Objective To understand the respiratory protection competency of staff in hospitals.Methods Staff from six hospitals of different levels and characteristics in Beijing were selected,including doctors,nurses,medical technicians,and servicers,to conduct knowledge assessment on respiratory protection competency.According to exposure risks of respiratory infectious diseases,based on actual cases and daily work scenarios,content of respira-tory protection competency assessment was designed from three aspects:identification of respiratory infectious di-seases,transmission routes and corresponding protection requirements,as well as correct selection and use of masks.The assessment included 6,6,and 8 knowledge points respectively,with 20 knowledge points in total,all of which were choice questions.For multiple-choice questions,full marks,partial marks,and no mark were given respective-ly if all options were correct,partial options were correct and without incorrect options,and partial options were correct but with incorrect options.Difficulty and discrimination analyses on question of each knowledge point was conducted based on classical test theory.Results The respiratory protection competency knowledge assessment for 326 staff members at different risk levels in 6 hospitals showed that concerning the 20 knowledge points,more than 60％participants got full marks for 6 points,while the proportion of full marks for other questions was relatively low.Less than 10％participants got full marks for the following 5 knowledge points:types of airborne diseases,types of droplet-borne diseases,conventional measures for the prevention and control of healthcare-associated infec-tion with respiratory infectious diseases,indications for wearing respirators,and indications for wearing medical protective masks.Among the 20 knowledge questions,5,1,and 14 questions were relatively easy,medium,and difficult,respectively;6,1,4,and 9 questions were with discrimination levels of ≥0.4,0.30-0.39,0.20-0.29,and ≤0.19,respectively.Conclusion There is still much room for hospital staff to improve their respiratory protection competency,especially in the recognition of diseases with different transmission routes and the indications for wearing different types of masks.

Objective To investigate the implementation of surveillance,prevention and control measures for healthcare-associated infection(HAI)in maternal and child healthcare(MCH)institutions,and provide policy evi-dence for optimizing HAI prevention and control in MCH institutions.Methods Stratified sampling was conducted among the MCH institutions at provincial,municipal and county levels in 8 provinces/autonomous regions.A uni-fied questionnaire was designed and the online survey was conducted through"Questionnaire Star".Results The data from 123 MCH institutions were included in the analysis.90.24％of the MCH institutions carried out compre-hensive surveillance on HAI.The ratios of MCH institutions which implemented targeted surveillance on HAI in neonatal intensive care unit(NICU),surgical site infection,multidrug-resistant organisms(MDROs)and HAI in intensive care units(non-NICU excluded)were 89.66％,85.96％,80.77％,and 74.19％,respectively.51.22％MCH institutions adopted information surveillance system on HAI cases.94.31％MCH institutions carried out surveillance on hand hygiene compliance.Over 90％MCH institutions carried out surveillance on environment hy-giene in high-risk departments.71.54％MCH institutions conducted centralized cleaning,disinfection,sterilization and supply for reusable medical instruments in the central sterile supply department(CSSD).Over 90％MCH insti-tutions established three-level pre-examination triage systems.86.18％set up transitional wards.MCH institutions generally adopted a management model with established effective communication,full appointment visits,and sepa-rate visits for special medical groups,such as registered pregnant women,high-risk newborns,healthcare groups,and long-term rehabilitation patients.However,the ratio of institutions conducting on-line follow-up visits was less than 50％.Conclusion MCH institutions have generally carried out comprehensive and targeted surveillance on HAI.Information surveillance need to be facilitated.Hand hygiene and environmental hygiene surveillance has been popularized to a certain extent at all levels of MCH institutions.The cleaning,disinfection,sterilization,and supply processes of reusable medical devices in a few MCH institutions are not standardized.Special medical populations get effective management.On-line healthcare is to be further promoted.

Objective:To explore influencing factors of the self-reported brief life quality satisfaction score(Brief-QoL) in patients with acromegaly and understand the persistent low Brief-QoL scores in cases achieving biochemical remission.Methods:This study included 836 acromegaly patients who were hospitalized at Peking Union Medical College Hospital between January 2012 and December 2020. We retrospectively examined how clinical characteristics, biochemical parameters, comorbidities, and symptoms influenced Brief-QoL. Among patients who achieved biochemical remission, differences in clinical symptoms and comorbidities were analyzed between the high and low quality of life groups.Results:Patients with well-controlled biochemical indicators at the last follow-up had generally high Brief-QoL. However, patients with symptoms such as headaches (47.8% in the low-score group vs 14.9% in the high-score group, P<0.001) and joint pain (69.6% in the low-score group vs 19.0% in the high-score group, P<0.001) had low Brief-QoL despite biochemical remission. Receiving combined treatment(52.4% in the low-score group vs 27.5% in the high-score group, P=0.030) and having comorbid diabetes or hyperlipidemia were significant factors leading to decreased quality of life. Conclusion:Brief-QoL is suitable for follow-up of outpatient patients. Early identification of factors affecting quality of life and timely intervention can facilitate the realization of standardized management.