Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Objective To explore the possibility and genetic identification method of constructing a hepatocyte-specific NLRP3 gene knockout mouse model by using Cre-LoxP system gene knockout technology.Methods Phase one:mice specifically expressing the albumin promoter-Cre(AlbCre)recombinase in hepatocytes were mated with NLRP3flox/flox mice,and the hepatocyte-specific NLRP3 gene knockout mice with the genotype of NLRP3flox/flox/AlbCre+/-(hepatocyte NLRP3 knockout group)and the control mice in the same litter with the genotype of NLRP3flox/flox/AlbCre-/-(control group in the same litter)were obtained after two generations of selection and mating.The second stage was the mass reproduction stage.Mating NLRP3flox/flox/AlbCre+/-target mice with NLRP3flox/flox mice could quickly obtain a large number of experimental target mice and control mice in the same litter.The DNA was extracted from the tails of mice after numbering,and the offspring genotype was identified by PCR.qPCR and Western blot were used to detect the mRNA and protein expression levels of NLRP3 gene in the liver tissue.HE staining was used to observe the morphological changes in liver tissues,and serum liver transaminases and inflammatory factors were detected.The changes in body weight,liver-to-body ratio and special circumstances during reproduction and development of mice in the two groups were observed.Results The offspring genotype of the target mice in the F2 generation was consistent with theoretical result of NLRP3flox/flox/AlbCre+/-.The mRNA and protein levels of NLRP3 in liver tissues of mice in the hepatocyte NLRP3 knockout group were significantly lower than those in the control group in the same litter(P<0.05).The mice in the hepatocyte NLRP3 knockout group was not affected in terms of growth,development and reproduction after the NLRP3 gene knockout.There were no statistically significant differences in the body weight,liver-to-body ratio,liver tissue morphology,serum liver transaminase or inflammatory factors between the hepatocyte NLRP3 knockout group and the control group in the same litter(P>0.05).Conclusion The Cre-LoxP gene knockout technology can be used to successfully construct a hepatocyte-specific NLRP3 gene knockout mouse model,providing an important technical support for the next step of studying the function of the NLRP3 gene in the liver at the animal level.

Objective:To investigate the effect of Qinggan Bupi Jiangtang Decoction combined with acupuncture on glucose and lipid metabolism and cytokines in patients with overweight/obese T2DM.Methods:Randomized controlled trial. A total of 104 patient with overweight/obese T2DM who were admitted to the Shanghai Municipal Hospital of Traditional Chinese Medicine of Shanghai University of Traditional Chinese Medicine from September 2022 to March 2023 were selected as the research subjects. They were randomly divided into the control group (52 cases) and the combination group (52 cases). The control group was given conventional symptomatic treatment and treated with acupuncture. On this basis, the combination group was treated with Qinggan Bupi Jiangtang Decoction. The two groups were compared in terms of efficacy, TCM syndrome scores, glucose metabolism indicators, islet function indicators, lipid metabolism indicators, cytokines, and blood glucose control. Results:The total effective rate was 90.38% (47/52) in the combined group and 73.08% (38/52) in the control group, and the difference between the two groups was statistically significant ( χ2=5.22, P=0.022). After treatment, the TCM syndrome score (13.21±1.48 vs. 18.54±2.01, t=15.40) of the combination group was lower than that of the control group ( P<0.001). After treatment, the combination group FPG [(6.05 ± 1.01) mmol/L vs. (7.26 ± 1.13) mmol/L, t=5.73], 2 hPG [(8.23 ± 1.12) mmol/L vs. (10.41 ± 1.26) mmol/L, t=9.54], HbAlc [(5.84 ± 0.84) % vs. (6.31 ± 0.93) %, t=2.84] and HOMA-IR (2.57 ± 0.26 vs. 2.86 ± 0.30, t=3.75) were lower than those in the control group ( P<0.05), and HOMA-β (61.34 ± 6.75 vs. 56.69 ± 5.72, t=5.87) was higher than that of the control group ( P<0.05). After treatment, the combination group TC, TG and LDL-C were lower than those in the control group ( t values were 10.25, 5.35, 3.51, respectively, P<0.01), HDL-C was higher than that of the control group ( t=11.59, P<0.01). After treatment, the combination group CTRP12 [(296.05 ± 30.11) ng/L vs. (280.23 ± 28.44) ng/L, t=2.76], FGF-21 [(184.12 ± 19.05) μg/L vs. (170.04 ± 17.03) μg/L, t=2.77], Nesfatin1 [(0.92 ± 0.10) μg/L vs. (0.77±0.08) μg/L, t=5.99] and lipidin levels [(4.89±0.51) mg/L vs. (4.12±0.48) mg/L, t=8.58] were higher than those in the control group ( P<0.01). The combined group composite endpoint achievement rate was 53.85% (28/52), the 12-week HbA1c achievement rate was 80.77% (42/52), and the rate of no weight increase was 84.62% (44/52). The control group's composite endpoint achievement rate was 34.62% (18/52), the 12-week HbA1c achievement rate was 61.54% (32/52), and the rate of no weight increase was 67.31% (35/52). The differences between the two groups were statistically significant ( χ2 values were 3.90, 4.69, 4.27, respectively, and the P values were 0.048, 0.030, 0.039, respectively). The adverse reactions of the two groups were mainly mild nausea, skin rash and pruritus, the incidence of which was 15.38% (8/52) in the combination group and 9.62% (5/52) in the control group, and there was no significant difference between the two groups ( χ2=0.79, P=0.374). Conclusion:The therapeutic effect of Qinggan Bupi Jiangtang Decoction combined with acupuncture on overweight/obese T2DM patients is relatively clear, and it can regulate the glucose and lipid metabolism and cytokines of patients.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Objective To explore the possibility and genetic identification method of constructing a hepatocyte-specific NLRP3 gene knockout mouse model by using Cre-LoxP system gene knockout technology.Methods Phase one:mice specifically expressing the albumin promoter-Cre(AlbCre)recombinase in hepatocytes were mated with NLRP3flox/flox mice,and the hepatocyte-specific NLRP3 gene knockout mice with the genotype of NLRP3flox/flox/AlbCre+/-(hepatocyte NLRP3 knockout group)and the control mice in the same litter with the genotype of NLRP3flox/flox/AlbCre-/-(control group in the same litter)were obtained after two generations of selection and mating.The second stage was the mass reproduction stage.Mating NLRP3flox/flox/AlbCre+/-target mice with NLRP3flox/flox mice could quickly obtain a large number of experimental target mice and control mice in the same litter.The DNA was extracted from the tails of mice after numbering,and the offspring genotype was identified by PCR.qPCR and Western blot were used to detect the mRNA and protein expression levels of NLRP3 gene in the liver tissue.HE staining was used to observe the morphological changes in liver tissues,and serum liver transaminases and inflammatory factors were detected.The changes in body weight,liver-to-body ratio and special circumstances during reproduction and development of mice in the two groups were observed.Results The offspring genotype of the target mice in the F2 generation was consistent with theoretical result of NLRP3flox/flox/AlbCre+/-.The mRNA and protein levels of NLRP3 in liver tissues of mice in the hepatocyte NLRP3 knockout group were significantly lower than those in the control group in the same litter(P<0.05).The mice in the hepatocyte NLRP3 knockout group was not affected in terms of growth,development and reproduction after the NLRP3 gene knockout.There were no statistically significant differences in the body weight,liver-to-body ratio,liver tissue morphology,serum liver transaminase or inflammatory factors between the hepatocyte NLRP3 knockout group and the control group in the same litter(P>0.05).Conclusion The Cre-LoxP gene knockout technology can be used to successfully construct a hepatocyte-specific NLRP3 gene knockout mouse model,providing an important technical support for the next step of studying the function of the NLRP3 gene in the liver at the animal level.

OBJECTIVES: To report the development, validation, and findings of the Multi-dimensional Attention Rating Scale (MARS), a self-report tool crafted to evaluate six-dimension attention levels. METHODS: The MARS was developed based on Classical Test Theory (CTT). Totally 202 highly educated healthy adult participants were recruited for reliability and validity tests. Reliability was measured using Cronbach's alpha and test-retest reliability. Structural validity was explored using principal component analysis. Criterion validity was analyzed by correlating MARS scores with the Toronto Hospital Alertness Test (THAT), the Attentional Control Scale (ACS), and the Attention Network Test (ANT). RESULTS: The MARS comprises 12 items spanning six distinct dimensions of attention: focused attention, sustained attention, shifting attention, selective attention, divided attention, and response inhibition.As assessed by six experts, the content validation index (CVI) was 0.95, the Cronbach's alpha for the MARS was 0.78, and the test-retest reliability was 0.81. Four factors were identified (cumulative variance contribution rate 68.79%). The total score of MARS was correlated positively with THAT (r = 0.60, P < 0.01) and ACS (r = 0.78, P < 0.01) and negatively with ANT's reaction time for alerting (r = -0.31, P = 0.049). CONCLUSIONS The MARS can reliably and validly assess six-dimension attention levels in real-world settings and is expected to be a new tool for assessing multi-dimensional attention impairments in different mental disorders.
Humans ; Adult ; Male ; Attention/physiology* ; Female ; Middle Aged ; Reproducibility of Results ; Young Adult ; Psychometrics

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To evaluate the efficacy of Qinggan Bupi Jiangtang Decoction combined with western medicine in the treatment of adult type 2 diabetes mellitus (T2DM) with with liver hyperactivity and spleen deficiency syndrome.Methods:Prospective cohort study. A total of 103 T2DM patients with liver hyperactivity and spleen deficiency syndrome in the Department of endocrinology of Shanghai Municipal Hospital of Traditional Chinese Medicine from February 2020 to February 2021 were randomly divided into the observation group (52 cases) and the control group (51 cases) according to random number table method. Both groups were treated with conventional western medicine, the control group was treated with sitagliptin phosphate on the basis of routine treatment, and the observation group was treated with Qinggan Bupi Jiangtang Decoction on the basis of routine treatment. Both groups were treated for 12 weeks. TCM symptom scores were performed before and after treatment. The FPG, 2hPBG, HbA1c and fasting insulin (FINS) were detected by dry chemistry method and Roche electroluminescence method, and insulin resistance index (HOMA-IR) was calculated. The clinical efficacy was evaluated by dynamic blood glucose monitoring indexes TIR (percentage of time when glucose was in the range of 3.9-10.0 mmol/L), TAR (percentage of time when glucose was higher than the target range ≥ 11.1 mmol/L) and TBR (percentage of time when glucose was lower than the target range <3.9 mmol/L).Results:The total effective rate was 92.3% (48/52) in the observation group and 56.9% (29/51) in the control group ( χ2=15.32, P<0.01). The score of TCM syndrome in the observation group was significantly lower than that of the control group ( t=6.30, P<0.01). The compliance rate of HbA1c in the observation group was 46.2% (24/52) and that of the control group was 23.5% (12/51). There was significant difference between the two groups ( χ2=5.80, P=0.016). Compared with the groups before treatment, MAGE, TAR, TBR significantly decreased and TIR significantly increased in both groups after treatment ( P<0.01), but there was no significant difference between the two groups after treatment ( t values were 0.78, 1.06, 0.22 and 1.45, respectively, P>0.05). Compared with the groups before treatment, the levels of FPG, 2 hPBG and HbA1c in the two groups significantly decreased after treatment ( P<0.01), but there was no significant difference between the two groups after treatment ( t values were 1.32, 0.18,1.50, respectively, P>0.05). Compared with the groups before treatment, the levels of FINS and HOMA-IR in the two groups significantly decreased after treatment ( P<0.01), but there was no significant difference between the two groups after treatment ( t values were 1.25, 0.51, respectively, P>0.05). There were no adverse reactions in the observation group, 2 cases of mild nausea and 1 case of transient diarrhea in the control group. There was no significant difference between the two groups ( χ2=3.15, P=0.118). Conclusion:Qinggan Bupi Jiangtang Decoction combined with routine treatment can improve the blood glucose level, TIR and blood glucose standard rates of adult T2DM with liver hyperactivity and spleen deficiency syndrome, and the curative effect is equivalent to sitagliptin phosphate tablets.