Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Objective:To analyze the risk factors of Mycoplasma pneumoniae（MP）lobar pneumonia with plastic bronchitis（PB）in pediatric patients，and to establish a risk nomogram prediction model.Methods:The medical informations were collected from pediatric patients diagnosed with MP lobar pneumonia who performed bronchoscopy during hospitalization in the Department of Pediatrics at the Second Affiliated Hospital of Air Force Military Medical University from April 2023 to December 2023.According to the bronchoscopic findings，the patients were divided into PB group and non-PB group.The clinical medical records and ancillary diagnostic findings were retrospectively analyzed.A multivariate Logistic regression model was used to analyze the independent risk factors for children with MP lobar pneumonia complicated with PB.A nomogram model was constructed to predict the risk of PB occurrence. Calibration curves and Hosmer-Lemeshow goodness-of-fit test were used to evaluate the predictive value of the nomogram model for MP lobar pneumonia with PB. The receiver operating characteristic (ROC) curve was used to assess the diagnostic efficacy.Results:A total of 357 pediatric patients diagnosed with MP lobar pneumonia were included，with 92 cases in PB group and 265 cases in non-PB group. No statistically significant differences in gender and age were observed between the two groups（ P>0.05）.The duration of fever and the hospitalization time in PB group were longer than those in non-PB group. The incidences of pleural effusion，consolidation area of a single lung lobe ≥2/3 and atelectasis on chest CT were higher in PB group compared to non-PB group. Additionally,the levels of neutrophil/lymphocyte ratio，C-reactive protein，procalcitonin，D-dimer（D-D），alanine aminotransferase(ALT)，aspartate aminotransferase，lactate dehydrogenase，α-hydroxybutyrate dehydrogenase，interferon-γ（IFN-γ），interleukin（IL）-6，IL-10 and IFN-γ/IL-4 ratio in PB group were higher than those in non-PB group（all P<0.05）.Logistic regression analysis showed elevated D-D, ALT and IFN-γ, pleural effusion and consolidation area of a single lung lobe ≥2/3 were independent risk factors for PB.The nomogram prediction model constructed by the model demonstrated good goodness-of-fit (χ 2=11.316， P=0.184) and provided significant clinical net benefits within a risk threshold range of 0.09–0.65. The area under the ROC curve for combined prediction was 0.771（95% CI 0.716-0.826），with a sensitivity of 0.707 and specificity of 0.706. Conclusion:In children with MP lobar pneumonia, elevated laboratory markers (D-D, ALT, IFN-γ) and imaging features (pleural effusion, consolidation area of a single lung lobe ≥2/3) are critical predictors for early diagnosis of PB.The nomogram prediction model can be used to predict MP lobar pneumonia with PB in early stage.

Objective:This study aims to evaluate the efficacy of levosimendan in elderly patients with acute heart failure across varying levels of renal function, utilizing real-world data.Methods:We conducted a retrospective cohort study involving 699 elderly patients with acute heart failure who were hospitalized at the Second Xiangya Hospital of Central South University and received positive inotropic drugs between January 2015 and December 2022.The median age of the participants was 71 years(interquartile range, 66 to 77), with 61.9% being male.Among these patients, 171 received non-levosimendan positive inotropic drugs(non-levosimendan group), while 528 were treated with levosimendan(levosimendan group).Baseline clinical data collected during hospitalization were analyzed.The primary outcomes assessed included the reduction in N-terminal pro-brain natriuretic peptide(NT-proBNP)levels following treatment, as well as mortality rates within 30 days and one year.Secondary outcomes encompassed the length of hospital stay and in-hospital mortality.Patients were categorized based on their estimated glomerular filtration rate(eGFR)prior to treatment, with groups defined as those with eGFR≥60 ml·min -1·1.73(m -1) 2 and those with eGFR between 15 and <60 ml·min -1·1.73(m -1) 2.The impact of levosimendan treatment on heart failure improvement and clinical prognosis was analyzed using a double robust method, which accounted for patients with varying levels of renal function. Results:In comparison to the non-levosimendan group, a significantly higher proportion of patients in the levosimendan group exhibited decreased NT-proBNP levels(31.0% vs.47.0%, P<0.001).However, there were no significant differences regarding the length of hospital stay, in-hospital mortality, or mortality rates at 30 days and 1 year(all P>0.05).After applying the double robust method for adjustment, levosimendan was shown to significantly reduce NT-proBNP levels( OR=1.553, 95% CI: 1.225-1.972, P<0.001), although it did not result in a significant improvement in 30-day or 1-year mortality rates.In patients with an eGFR of 15-<60 ml·min -1·1.73(m -1) 2, levosimendan significantly reduced NT-proBNP levels( OR=1.797, 95% CI: 1.308-2.481, P<0.001)and decreased 30-day mortality( HR=0.536, 95% CI: 0.292-0.986, P=0.045).Similarly, in patients with eGFR ≥60 ml·min -1·1.73(m -1) 2, levosimendan significantly reduced NT-proBNP levels( OR=1.965, 95% CI: 1.325-2.933, P<0.001), but did not improve 30-day mortality.Across varying levels of renal function, levosimendan had no significant effect on 1-year mortality. Conclusions:Levosimendan can significantly enhance cardiac function in elderly patients experiencing acute heart failure, irrespective of varying levels of renal function.Notably, greater benefits regarding short-term mortality were observed in patients with an eGFR of 15-<60 ml·min -1·1.73(m -1) 2.

Objective To understand the experience of fall alertness in elderly patients with rheumatoid arthritis and to provide references for the development of targeted nursing intervention strategies.Methods 13 elderly patients with rheumatoid arthritis,who were admitted to the Department of Rheumatology and Immunology of a tertiary hospital in Guizhou Province from February to April 2024,were selected through purposive sampling.Phenomenological qualitative research methods were used,with semi-structured in-depth interviews.Data were analyzed using Colaizzi's seven-step method,and themes were extracted.Results 3 main themes and 9 sub-themes were identified:the process of fall risk perception(reshaping fall risk cognition,establishing emotional coping mechanism,enhancing fall alertness effect),behavioral responses to fall alertness(creating a safe living environment,regularizing daily routine plan),and needs for fall prevention support(need for fall prevention knowledge,home rehabilitation care needs,intelligent device usage needs,psychosocial support needs).Conclusion Clinical medical staff should pay attention to the transformation process of fall risk perception in elderly rheumatoid arthritis patients,accurately identify patients'fall support needs in practice,and guide patients to adopt appropriate fall alert response behaviors through innovative fall demand support interaction paths and the construction of social support network systems,in order to improve patients'fall alertness and reduce their fall risk.

Aim To systematically investigate the ac-tive components,targets,and regulatory pathways of Po-lygonum capitatum in intervening atherosclerosis(AS)through network pharmacology,molecular docking and animal experiments.Methods Active components of Polygonum capitatum and AS-related targets were screened and identified through database searches.Protein-protein interaction(PPI)network analysis was performed using the STRING database,followed by GO and KEGG enrichment analyses via the David plat-form.Molecular docking validation was conducted with AutoDock.An AS model was established in Syrian golden hamsters fed a high-fat diet.Predicted pathways and targets were validated using qPCR,ELISA,and histopathological assessment of aortic and hepatic tis-sues via HE staining.Results Network pharmacology identified 27 potential active components of Polygonum capitatum(primarily flavonoids such as quercetin and luteolin)and 110 drug-disease intersection targets,in-cluding core targets MMP-9,ALB,and AKT1.GO and KEGG analyses enriched 593 and 125 pathways,re-spectively,with the NF-κB inflammatory pathway,TNF signaling pathway and lipid metabolism/atherosclerosis pathways highlighted as key mechanisms.Animal ex-periments demonstrated that Polygonum capitatum im-proved serum lipid profiles(reduced TC,TG,LDL-C)in AS hamsters,suppressed the MMP-9/NF-κB signa-ling pathway(downregulated MMP-9,p65 phosphoryla-tion,TNF-α,and IL-6),and inhibited VSMC synthetic phenotypic transformation(upregulated α-SMA and myocardin)by downregulating MCPIP1.Additionally,Polygonum capitatum ameliorated aortic lesions and he-patic lipid deposition in AS hamsters.Conclusions Polygonum capitatum alleviates AS by synergistically regulating the MMP-9/NF-κB/MCPIP1 axis through flavonoid components,suppressing vascular inflammato-ry cascades and maintaining VSMC contractile pheno-types.This reflects Polygonum capitatum's multi-com-ponent,multi-pathway,and multi-target characteristics in combating AS.

Objective To observe the early changes of vault after implantation of posterior chamber phakic intraocular lens implantable collamer lens(ICL),and investigate the effect of different implantation axes on the early vault changes.Methods A prospective,parallel cohort study was performed,enrolling a total of 124 eyes of who underwent ICL(V4c)implantation in the refractive clinic.The changes of vault were observed by scheimpflug tomography(Pentacam)and anterior segment optical coherence tomography(CASIA2)at 1 day,1 week and 1 month after surgery.Results The ICL vault declined significantly by approximately(108.2±82.4)μm 1 week after surgery with the proportion of 16.6%±12.1%compared with the values 1 day after surgery(P<0.001),and then remained stable.Within 1 month after surgery,excluding the difference in vault baseline at 1 day after surgery,the proportion of vault decline in the middle vault group(250-749 μm)and the high vault group(≥750 μm)was similar,and there was no statistically significant difference.We analyzed the relationship between ICL axial directions and vault and found that the vault decline of the horizontal ICL group stabilized quickly at 1 week after surgery,and the vault decline of the vertical ICL group was more significant within 1 month after surgery(P<0.05).Conclusion The vault of the ICL shows a downward trend in the early stage after implantation.The middle vault group and ICL in the horizontal position stabilizes faster,and the downward trend of the high vault group or ICL in the vertical position is more obvious.

Objective To explore the targeted regulatory relationship of miR-330-5p on OY-TES-1 in glioblastoma and the effect of miR-330-5p/OY-TES-1 axis on the migration ability of glioblastoma.Methods Bioinformatics analysis was performed to analyze the expression level of miR-330-5p in patients with glioblastoma and its influence on prognosis and survival of patients.The glioblastoma cells U251 were divided into miR-330-5p minics group,minics-NC group,and miR-330-5p+OY-TES-1 overexpression group(miR-330-5p minics+pcDNA3.1-OY-TES-1).The effect of miR-330-5p on the activity of OY-TES-1 3'UTR region was detected by double luciferase reporter gene experiment.The expression of OY-TES-1 mRNA was detected by qRT-PCR.The effect of miR-330-5p/OY-TES-1 axis on the migration ability of glioblastoma cells was detected by Transwell migration assay.Results The expression of miR-330-5p in glioblastoma tissue was significantly lower than those in non-tumor brain tissue and low-grade glioma tissue(P<0.05).The survival time of glioblastoma patients with high expression of miR-330-5p was significantly longer than that of patients with low expression of miR-330-5p(P<0.05).After overexpression of miR-330-5p,the activity of OY-TES-1 3'UTR region was decreased(P<0.05).Compared with minics-NC group,the expression levels of OY-TES-1 mRNA of U251 and U87MG cells in miR-330-5p minics group were significantly decreased(P<0.01).Compared with minics-NC group,the numbers of migrating cells in miR-330-5p minics group and miR-330-5p+OY-TES-1 overexpression group were significantly decreased(P<0.05).Compared with miR-330-5p minics group,the number of migrating cells in miR-330-5p+OY-TES-1 overexpression group was significantly increased(P<0.01).Conclusion MiR-330-5p targets OY-TES-1 to inhibit the migration of glioblastoma.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Objective:To investigate the expression of indoleamine 2,3-dioxygenase 1(IDO1)in different types of breast cancer tissues and its relationship with patient prognosis and immune cell infiltration.Methods:RNA sequencing data of breast cancer and corresponding clinical information from the TCGA database were collected.The differential expression of IDO1 mRNA in various breast cancer tissues(different subtypes,stages,menopause statuses,and age groups)and adjacent normal tissues were analyzed.Breast cancer patients with significant differences in IDO1 mRNA expression were divided into high and low expression groups,and their disease-specific survival(DSS)was compared between the two groups.The relationship between IDO1 mRNA expression and immune cell infiltration in cancer tissues with significant DSS differences was analyzed.Immunohistochemistry was used to detect IDO1 protein expression in ER-negative,PR-negative,HER2-positive,and stage Ⅱ breast cancer tissues,to verify the data from the database.Results:IDO1 mRNA was highly expressed in breast cancer tissues but varied across different breast cancer types.IDO1 mRNA was highly expressed in breast cancer tissues of patients with ER-negative,PR-negative,HER2-positive,HER2-negative subtypes,stage Ⅱ,T2 stage,N0 stage,M0 stage,premenopausal,postmenopausal,and age≤60 years(P<0.05 or P<0.01,or P<0.001).In the ER-negative,PR-negative,HER2-positive,and stage Ⅱ subgroups,breast cancer tissues patients with high IDO1 mRNA expression had significantly higher DSS than those with low expression(P<0.05 or P<0.01).In ER-negative,PR-negative,HER2-positive,and stageⅡ breast cancer tissues,IDO1 mRNA expression was associated with immune cell infiltration,including activated dendritic cells(aDCs),Th1 cells,T cells,CD56dim NK cells,CTLs,and Treg cells(all P<0.001).IDO1 protein was highly expressed in ER-negative,PR-negative,HER2-positive,and stage Ⅱ breast cancer tissues(all P<0.001),consistent with the data from the database.Conclusion:IDO1 expression varies across different types of breast cancer tissues.The expression of IDO1 is associated with the prognosis and immune cell infiltration in ER-negative,PR-negative,HER2-positive,and at stage Ⅱ breast cancer patients.

Objective:To analyze the risk factors of Mycoplasma pneumoniae（MP）lobar pneumonia with plastic bronchitis（PB）in pediatric patients，and to establish a risk nomogram prediction model.Methods:The medical informations were collected from pediatric patients diagnosed with MP lobar pneumonia who performed bronchoscopy during hospitalization in the Department of Pediatrics at the Second Affiliated Hospital of Air Force Military Medical University from April 2023 to December 2023.According to the bronchoscopic findings，the patients were divided into PB group and non-PB group.The clinical medical records and ancillary diagnostic findings were retrospectively analyzed.A multivariate Logistic regression model was used to analyze the independent risk factors for children with MP lobar pneumonia complicated with PB.A nomogram model was constructed to predict the risk of PB occurrence. Calibration curves and Hosmer-Lemeshow goodness-of-fit test were used to evaluate the predictive value of the nomogram model for MP lobar pneumonia with PB. The receiver operating characteristic (ROC) curve was used to assess the diagnostic efficacy.Results:A total of 357 pediatric patients diagnosed with MP lobar pneumonia were included，with 92 cases in PB group and 265 cases in non-PB group. No statistically significant differences in gender and age were observed between the two groups（ P>0.05）.The duration of fever and the hospitalization time in PB group were longer than those in non-PB group. The incidences of pleural effusion，consolidation area of a single lung lobe ≥2/3 and atelectasis on chest CT were higher in PB group compared to non-PB group. Additionally,the levels of neutrophil/lymphocyte ratio，C-reactive protein，procalcitonin，D-dimer（D-D），alanine aminotransferase(ALT)，aspartate aminotransferase，lactate dehydrogenase，α-hydroxybutyrate dehydrogenase，interferon-γ（IFN-γ），interleukin（IL）-6，IL-10 and IFN-γ/IL-4 ratio in PB group were higher than those in non-PB group（all P<0.05）.Logistic regression analysis showed elevated D-D, ALT and IFN-γ, pleural effusion and consolidation area of a single lung lobe ≥2/3 were independent risk factors for PB.The nomogram prediction model constructed by the model demonstrated good goodness-of-fit (χ 2=11.316， P=0.184) and provided significant clinical net benefits within a risk threshold range of 0.09–0.65. The area under the ROC curve for combined prediction was 0.771（95% CI 0.716-0.826），with a sensitivity of 0.707 and specificity of 0.706. Conclusion:In children with MP lobar pneumonia, elevated laboratory markers (D-D, ALT, IFN-γ) and imaging features (pleural effusion, consolidation area of a single lung lobe ≥2/3) are critical predictors for early diagnosis of PB.The nomogram prediction model can be used to predict MP lobar pneumonia with PB in early stage.