Objective To evaluate the impact of intensified infection control measures on the incidence of health-care-associated infection(HAI)under the background of the reform of diagnosis-intervention packet(DIP)payment,and provide decision-making basis for HAI management under the reform of medical insurance payment.Methods The interrupted time series research design was used to collect the monitoring data of HAI in a tertiary first-class hospital from October 2021 to September 2024.The changing trend of HAI incidence was analyzed by piecewise li-near regression,and the intervention effect was evaluated by standardized infection ratio(SIR).Results From Oc-tober 2021 to September 2022,the incidence of HAI was 2.17％(95％CI:2.08％-2.26％),which dropped to 1.87％(95％CI:1.82％-1.92％)after the intervention.Piecewise linear regression analysis showed that the inci-dence of HAI decreased by 0.324％immediately after the intervention(95％CI:-0.481％--0.167％,P＜0.001),and the trend after the intervention changed significantly compared with that before the intervention(95％CI:-0.033％--0.009％,P=0.001).SIR analysis showed that the actual incidence during the entire intervention period was equivalent to 74.56％of the incidence in intervention period,gradually stabilized from 88.39％-93.81％at the beginning of the intervention to 67.03％-71.22％at the end of the study,and the intervention effect was sustained.Conclusion Intensified infection control measures under the background of the reform of DIP significantly reduce the incidence of HAI and improve the stability of infection control management,which provide new insights into the synergistic improvement of medical insurance payment and HAI management quality.

Objective To evaluate the impact of intensified infection control measures on the incidence of health-care-associated infection(HAI)under the background of the reform of diagnosis-intervention packet(DIP)payment,and provide decision-making basis for HAI management under the reform of medical insurance payment.Methods The interrupted time series research design was used to collect the monitoring data of HAI in a tertiary first-class hospital from October 2021 to September 2024.The changing trend of HAI incidence was analyzed by piecewise li-near regression,and the intervention effect was evaluated by standardized infection ratio(SIR).Results From Oc-tober 2021 to September 2022,the incidence of HAI was 2.17％(95％CI:2.08％-2.26％),which dropped to 1.87％(95％CI:1.82％-1.92％)after the intervention.Piecewise linear regression analysis showed that the inci-dence of HAI decreased by 0.324％immediately after the intervention(95％CI:-0.481％--0.167％,P＜0.001),and the trend after the intervention changed significantly compared with that before the intervention(95％CI:-0.033％--0.009％,P=0.001).SIR analysis showed that the actual incidence during the entire intervention period was equivalent to 74.56％of the incidence in intervention period,gradually stabilized from 88.39％-93.81％at the beginning of the intervention to 67.03％-71.22％at the end of the study,and the intervention effect was sustained.Conclusion Intensified infection control measures under the background of the reform of DIP significantly reduce the incidence of HAI and improve the stability of infection control management,which provide new insights into the synergistic improvement of medical insurance payment and HAI management quality.

A novel amide alkaloid,bursatamide A(1),featuring an unprecedented propyl-hexahydronaphthalene carbon frame-work,was isolated from the infrequently studied sea hare Bursatella leachi,alongside a new 3-phenoxypropanenitrile alkaloid,bursatellin B(2),and twelve known compounds.The structures of 1 and 2 were elucidated through comprehensive spectroscopic data analyses,while their relative and absolute configurations(ACs)were established through total synthesis and a series of quantum chem-ical calculations,including calculated electronic circular dichroism(ECD)spectra,optical rotatory dispersion(ORD)methods,and DP4+probability analyses.Bursatamide A(1)demonstrated inhibitory effects against the human pathogenic bacteria Listeria monocyt-ogenes and Vibrio cholerae.Erythro-bursatellin B(21),a diastereoisomer of 2,exhibited notable antibacterial activity against the fish pathogenic bacterium Streptococcus parauberis FP KSP28,with an MIC90 value of 0.0472 μg·mL-1.

Endosomal TLRs (TLR3/7/8/9) are highly analogous innate immunity sensors for various viral or bacterial RNA/DNA molecular patterns. Among them, TLR7, in particular, has been suggested to be a target for various inflammatory disorders and autoimmune diseases including systemic lupus erythematosus (SLE); but few small-molecule inhibitors with elaborated mechanism have been reported in literature. Here, we reported a well-characterized human TLR7-specific small-molecule inhibitor, TH-407b, with promising potency and negligible cytotoxicity through a novel binding mechanism. Notably, TH-407b not only effectively inhibited TLR7-mediated pro-inflammatory signaling in a variety of cultured cell lines but also demonstrated potent inflammation suppressing activities in primary peripheral blood mononuclear cells (PBMCs) derived from SLE patients. Furthermore, TH-407b showed prominent efficacy in vivo, improved survival rate and ameliorated symptoms of SLE model mice. To obtain molecular insights into the TH-407b derivatives' inhibition mechanism, we performed the structural analysis of TLR7/TH-407b complex using cryogenic electron microscopy (cryo-EM) method. As an atomistic resolution cryo-EM structure of the TLR family, it not only of value to facilitate structure-based drug design, but also shed light to methodology development of small proteins using EM. Significantly, TH-407b has unveiled an inhibition strategy for TLR7 via stabilizing its resting/inactivated state. Such a resting state could be generally applicable to all TLRs, rendering a useful method for targeting this group of important immunological receptors.

Objective To explore the safety and effectiveness of Mini-percutaneous nephrolithotomy (MPCNL)in the treatment of upper urinary stones in uygur children.Methods Retrospectively analyzed the date 158 cases of upper urinary stones in children treated by MPCNL in xinjiang hotan people's hospital from March to December 2016,117 cases of males and 41 cases of females,aged from 5 months to 14 years (average:2.59 years),including 112 cases of 5 months to 3 years old and 46 cases of 3 to 14 years old.There were 69 cases on the left,67 cases on the right and 22 cases on both sides.The average stone size was 2.3 cm × 1.8 cm.According to the size of the calculi,the percutaneous renal channel was selected between 12-18 F,the energy was selected for holmium laser lithotripsy,no perfusion pump was used and the hydrostatic pressure was controlled at 50 to 70 cm water column.Double J tube and renal fistula were placed postoperatively in 139 children;15 cases were not treated with renal fistula and 4 cases were completely free of tubulization.To observe the number and proportion of children with fever before and after operation.For multiple stones,use the accumulative maximum diameter calculation.To observe the changes of blood routine indexes before and after surgery,as well as operation time,puncture site,channel size and number,length of hospital stay,stone removal rate,stone composition and other postoperative complications.Counting data was expressed as a rate (％),and comparison between groups was performed by chi-square test.Results A total of 180 cases were successfully operated on kidney MPCNL.No complications above ClavienⅡ occurred.Two cases were treated with 1 unit of postoperative erythrocyte transfusion.The time of unilateral operation was 15 to 85 minutes with an average of 35 minutes.The first-stage stone clearance rate was 88.6％ (140/158) and the total stone clearance rate was 92.4％ (146/158).Postoperative hospitalization ranged from 3 to 8 days with an average of 6.2 days.Condusion MPCNL was used to treat upper urinary stones with high efficiency and safety and little damage for children with large stones or combined with water accumulation.Some appropriate children can be free of renal fistula or complete absence of tubulization to facilitate the recovery of children.

Fifty-two methyl xestospongoate analogues were designed, synthesized and evaluated for the antiproliferative activity. Starting from alkynyl methyl ester and diyne, methyl xestospongoate analogues 4(a-m)-7(a-m)were synthesized by Cadiot-Chodkiewitz coupling and Sonogashira coupling reactions. Their structures were identified by 1H NMR, 13C NMR and HREI-MS. The cytotoxic inhibiton activities in vitro of some compounds were evaluated against human cancer cells A549 and P-388 by a CCK-8 method. Among them, compound 6k exhibited potent cell growth inhibitory activity against A549 and P-388 cancer cells, with IC50 values of 9. 36 and 9. 62 μmol/L, respectively.

The incidence of osteoporotic vertebral fractures (OCVF) has increased year by year.MRI is noninvasive and nonradiative,which can be used to observe the type,pathological stage and severity of OCVF.In recent years,MRI has become an important method to evaluate OCVF,which can provide imaging basis for clinical choice of treatment.The research progresses of MRI in OCVF were reviewed in this article.

Aim To examine the effect of zacopride,a specific inward rectifier potassium channel(IK1)agonist,on L-thyroxine(T4)-induced ventricular remodeling and the underlying mechanism.Methods SD rats were randomly divided as control,L-thyroxine(L-thy,1 mg·kg-1·d-1,ig,10 d)model,L-thy +zacopride(5,15,50 μg·kg-1,respectively,ip),L-thy+zacopride(15 μg·kg-1)+chloroquine(7.5 μg·kg-1,ip)and L-thy+captopril(100 mg·kg-1·d-1,drinking water)groups.Echocardiography and cardiac hypertrophic indexes were measured to confirm the establishment of the ventricular remodeling model.The changes of IK1 and L-calcium current(ICa-L)were detected by whole cell patch clamp technique.The confocal microscopy and fluorescent indicator Fluo-4 were applied to examine the intracellular Ca2+ concentration([Ca2+]i)of isolated adult rat ventricular myocytes.Results L-thyroxine induced left ventricular hypertrophy with increased ratio of heart weight(HW)to body weight(HW·BW-1),ratio of left ventrical weight(LVW)to body weight(LVW·BW-1),left ventricular dimension in diastole(LVIDd),left ventricular dimension in systole(LVIDs),interventricular septum thickness(IVS)and decreased ejection fraction(EF),fractional shortening(FS)(P<0.01).Patch clamp data suggested IK1 was downregulated,while ICa-L was upregulated(P<0.01).In isolated adult cardiomyocytes,L-thyroxine increased the cell area and [Ca2+]i(P<0.01).Zacopride treatment obviously alleviated cardiac remodeling,improved cardiac function,reversed the changes of IK1 and ICa-L,and significantly attenuated intracellular calcium overload(P<0.01).The optimum dose of zacopride in vivo was 15 μg·kg-1 at which the effect was compared favourably with captopril,a classical anti-remodeling agent.Low-dose IK1 atagonist chloroquine could reverse the effect of zacopride(P<0.01).Conclusion Via activating IK1,zacopride could significantly decrease Ca2+ influx and intracellular calcium overload thereby inhibiting L-thyroxine-induced cardiac ventricular remodeling.

OBJECTIVE:To systematically evaluate therapeutic efficacy and safety of Yupingfeng powder in adjavant therapy of allergic rhinitis,and to provide evidence-based reference for clinical treatment. METHODS:Retrieved from Wanfang database,VIP,CJFD,CBM,Cochrane Library,EMBase and PubMed,RCTs about Yupingfeng powder combined with chemical medicine (trial group)vs. chemical medicine alone in the treatment of allergic rhinitis were collected. Meta-analysis was conducted by using Rev Man 5.2 statistical software after data extraction and quality evaluation according to Cochrane system evaluation method 5.1.0. RESULTS:A total of 15 RCTs were included,invovling 1366 patients. The results of Meta analysis showed that response rate [OR=3.95,95%CI(2.80,5.58),P<0.001],recurrence rate [OR=0.37,95%CI(0.22,0.63),P<0.001] and the incidence of ADR [OR=0.15,95%CI(0.06,0.35),P<0.001] in trial group were significantly higher than control group,with statistical significance. CONCLUSIONS:Yupingfeng powder in adjuvant therapy of allergic rhinitis show good therapeutic efficacy and can reduce recur-rence rate with good safety.

Objective To investigate th grade of CT in colonic diverticulitis and the value in predicting clinical treatment.Methods CT data of totally 41 patients with colonic diverticulitis were analyzed retrospectively.According to the imaging signs,the grading of diverticulitis cases was performed.Patients with level 1 to 3 were considered as only need non-operative treatment,those with level 4 or 5 were considered as need surgical treatment.The consistency of predictive treatment plans were contrasted with clinical practical treatment results.Results The CT features of colonic diverticulitis were saclike protrusions bulged outside of the bowel wall with colon wall thickening in 40 cases (40/41,97.56％) and fuzzy pericolonal fat space in 39 cases (39/41,97.12％).The diagnostic accuracy of preoperative CT grading in predictive treatment plan was 85.37 ％ (36/41).Conclusion Colonic diverticulitis have certain characteristic CT findings.CT grading of diverticulitis is helpful to formulate appropriate clinical treatment.