Objective To analyze the monitoring of healthcare-associated infection(HAI)in the intensive care unit(ICU)over the past 12 years based on Joinpoint regression model,and evaluate the trend changes and relevant fac-tors of HAI incidence.Methods ICU patients in a tertiary first-class hospital from January 2012 to December 2023 were selected and performed prospective monitoring.Trend changes of HAI incidence and the correlation with con-sumption of hand hygiene products as well as HAI management measures were analyzed.Results From 2012 to 2023,6 929 ICU patients were included in the monitoring,543 patients had 655 episodes of HAI,with incidence and case incidence of HAI being 7.84％ and 9.45％,respectively.The average severity of the disease was 3.62,and the adjusted HAI incidence was 2.17％.The daily incidence of ventilator-associated pneumonia(VAP),cathe-ter-associated urinary tract infection(CAUTI),and central line-associated bloodstream infection(CLABSI)were 6.19‰,3.45‰,and 1.23‰,respectively.The consumption of hand hygiene products was 122.98 mL/bed-day.The compliance rate and correct rate of hand hygiene were 90.63％and 90.46％,respectively.From 2012 to 2023,incidence of HAI(51.29％vs 4.39％),case incidence of HAI(72.41％vs 4.94％),the adjusted incidence of HAI(15.98％vs 1.04％),daily incidence of VAP(22.50‰ vs 4.33‰),daily incidence of CAUTI(14.23‰ vs 1.64‰),and daily incidence of CLABSI(10.60‰ vs 0.20‰)all decreased significantly(all P＜0.05).Both con-sumption of hand hygiene products(75.16 mL/bed-day vs 147.35 mL/bed-day)and correct rate of hand hygiene(85.00％vs 90.28％)increased significantly(both P＜0.05).A total of 1 946 pathogens were detected,with an increase in the proportion of Staphylococcus aureus(1.30％ vs 9.57％)and a decrease in the proportion of fungi(11.04％vs 1.74％).The daily consumption of hand hygiene products negatively correlated with the incidence of HAI,the case incidence of HAI,as well as the daily incidence of CAUTI and CLABSI(all P＜0.05).Incorpora-ting HAI real-time monitoring system and HAI management into performance assessment could decrease HAI-rela-ted incidence(P＜0.05).Conclusion HAI-related incidence presents a downward trend.Scientific and comprehen-sive HAI prevention and control management measures such as healthcare workers'hand hygiene management,on-line HAI real-time monitoring system,and incorporating HAI management into performance assessment can de-crease HAI-related incidence and promote the improvement of medical quality.

Objective To analyze the monitoring of healthcare-associated infection(HAI)in the intensive care unit(ICU)over the past 12 years based on Joinpoint regression model,and evaluate the trend changes and relevant fac-tors of HAI incidence.Methods ICU patients in a tertiary first-class hospital from January 2012 to December 2023 were selected and performed prospective monitoring.Trend changes of HAI incidence and the correlation with con-sumption of hand hygiene products as well as HAI management measures were analyzed.Results From 2012 to 2023,6 929 ICU patients were included in the monitoring,543 patients had 655 episodes of HAI,with incidence and case incidence of HAI being 7.84％ and 9.45％,respectively.The average severity of the disease was 3.62,and the adjusted HAI incidence was 2.17％.The daily incidence of ventilator-associated pneumonia(VAP),cathe-ter-associated urinary tract infection(CAUTI),and central line-associated bloodstream infection(CLABSI)were 6.19‰,3.45‰,and 1.23‰,respectively.The consumption of hand hygiene products was 122.98 mL/bed-day.The compliance rate and correct rate of hand hygiene were 90.63％and 90.46％,respectively.From 2012 to 2023,incidence of HAI(51.29％vs 4.39％),case incidence of HAI(72.41％vs 4.94％),the adjusted incidence of HAI(15.98％vs 1.04％),daily incidence of VAP(22.50‰ vs 4.33‰),daily incidence of CAUTI(14.23‰ vs 1.64‰),and daily incidence of CLABSI(10.60‰ vs 0.20‰)all decreased significantly(all P＜0.05).Both con-sumption of hand hygiene products(75.16 mL/bed-day vs 147.35 mL/bed-day)and correct rate of hand hygiene(85.00％vs 90.28％)increased significantly(both P＜0.05).A total of 1 946 pathogens were detected,with an increase in the proportion of Staphylococcus aureus(1.30％ vs 9.57％)and a decrease in the proportion of fungi(11.04％vs 1.74％).The daily consumption of hand hygiene products negatively correlated with the incidence of HAI,the case incidence of HAI,as well as the daily incidence of CAUTI and CLABSI(all P＜0.05).Incorpora-ting HAI real-time monitoring system and HAI management into performance assessment could decrease HAI-rela-ted incidence(P＜0.05).Conclusion HAI-related incidence presents a downward trend.Scientific and comprehen-sive HAI prevention and control management measures such as healthcare workers'hand hygiene management,on-line HAI real-time monitoring system,and incorporating HAI management into performance assessment can de-crease HAI-related incidence and promote the improvement of medical quality.

Delirium is an acute brain dysfunction syndrome characterized by confusion and difficulty concentrating,which mainly affects intensive care unit patients and elderly inpatients.Treatment is expensive and may also lead to increased risks of serious complications and death.The complex etiology and unknown pathological mechanisms of delirium mean that clinical drug treatment is largely ineffective.Animal models therefore provide a powerful tool to help understand the mechanism of delirium,screen new drugs,and study potential intervention measures.We review experimental research related to delirium animal models worldwide,and summarize the latest progress in the construction and evaluation of these models from the aspects of animal selection,model construction method,and model evaluation,to provide a reference for further experimental research based on delirium animal models.

Severe infection is a significant threat to patient safety and survival.As the main treat-ment for hospital acquired infections,meropenem is limited in its effectiveness due to the emergence of drug resistance,especially after long-term use of antibiotics.Therefore,optimizing the efficacy of an-tibiotics such as meropenem and avoiding microbi-al resistance has become an urgent issue to be ad-dressed.Therapeutic drug monitoring(TDM),as an important tool for achieving personalized drug ad-ministration,is increasingly recognized as an impor-tant strategy for optimizing antibiotic concentra-tion,avoiding treatment failure and toxicity in criti-cally ill patients and patients with renal insufficien-cy.By reviewing the current application status,pharmacokinetics,and TDM guidance of meropen-em,clinical references are provided for the treat-ment of critically ill patients and patients with renal insufficiency,and guidance and support are provid-ed for optimizing antibiotic treatment.

Severe infection is a significant threat to patient safety and survival.As the main treat-ment for hospital acquired infections,meropenem is limited in its effectiveness due to the emergence of drug resistance,especially after long-term use of antibiotics.Therefore,optimizing the efficacy of an-tibiotics such as meropenem and avoiding microbi-al resistance has become an urgent issue to be ad-dressed.Therapeutic drug monitoring(TDM),as an important tool for achieving personalized drug ad-ministration,is increasingly recognized as an impor-tant strategy for optimizing antibiotic concentra-tion,avoiding treatment failure and toxicity in criti-cally ill patients and patients with renal insufficien-cy.By reviewing the current application status,pharmacokinetics,and TDM guidance of meropen-em,clinical references are provided for the treat-ment of critically ill patients and patients with renal insufficiency,and guidance and support are provid-ed for optimizing antibiotic treatment.

OBJECTIVE To separate and identify the chemical constituents of the n-butanol fraction from the stems of Clerodendrum trichotomum ，and to investigate their antitumor activities in vitro . METHODS The ethanol extracts were obtained with 85% ethanol from dried stems of C. trichotomum. After dispersed with water ，ethanol extracts were distributed by petroleum ether，ethyl acetate and n-butanol in turn ，then concentrated under reduced pressure to obtain the fractions of each extraction part . The n-butanol fraction from the stems of C. trichotomum was isolated and purified by macroporous resin D 101 column chromatography and various chromatographic techniques including silica gel ，hydroxypropyl glucan gel and Toyopearl HW -40F macroporous resin and so on . The structures of them were identified by physical and chemical properties ，MS and NMR . All these compounds were evaluated for cytotoxic activities against 4 kinds of human tumor cells such as cultured K 562，MCF-7，A549 and HepG2，using the MTT assay . RESULTS Fourteen chemical constituents were isolated and identified as teuvincenone B （1）， uncinatone（2），villosin C （3），syringaresinol（4），syringaresinol-4ʹ-O-β-glucopyranoside（5），3，12-O-β-D-diglucopyranosyl-11，16- dihydroxyabieta-8，11，13-triene（6），glypentoside C （7），martynoside（8），isomartynoside（9），2-（4-hydroxyphenyl）ethanol-O-β-D- glucopyranosyl-（1→2）-O- β -D-glucopyranoside（10），3，4-dimethoxyphenyl-1-O- β -D-apiofuranosyl （1→2） - β -D- glucopyranoside（11）， 2，6-dimethoxy-4-hydroxy-1-O- β -D- glucopyranoside（12），adenosine（13）and cistanoside F （14）. In vitro anti-tumor activity studies showed that compounds 1-3 showed certa in inhibitory activities against tumor cellproliferation，among which compound 2 displayed the strongest inhibitory activity against MCF -7，A549 and HepG 2 cells，and their IC 50 values were 25.00，22.34 and 12.50 μmol/L respectively ；only compound 3 showed stronger inhibitory activity against K562 cell with IC 50 of 28.41 μmol/L. CONCLUSIONS Among them ，compounds 10 to 13 are isolated from genus Clerodendrum for the first time ，compounds 4，5，14 were isolated from C. trichotomum for the first time . The abietane diterpenoids （compounds 1-3）have better inhibitory activities against above four tumor cell lines .

Objective To investigate the clinical values of the leukocyte count,D-dimer,histidine decarboxylase (HDC) and intestinal fatty acid binding protein (I-FABP) for diagnosing acute intestinal obstruction.Methods Sixty patients who treated in China-Japan Union Hospital of Jilin University from January 2017 to January 2018 were collected prospectively,and were divided into strangulated intestinal obstruction (STR-IO) group (n =20),simple intestinal obstruction (SIM-IO) group (n =20) and peritonitis group (n =20).Twenty healthy volunteers were collected as control group.Automatic blood cell analyzer was used to detecting the leukocyte count.The concentration of plasma D-dimer was detected by immune turbidimetry method.The concentration of serum HDC and I-FABP were measured by enzyme linked immunosorbent assay (ELISA) method.Compared the above indicators of four groups of samples.The measurement data are expressed as mean ± standard deviation (Mean ± SD).Tamhane's T2 and Dunnett's T3 methods were used to comparison between groups.Estimation of receiver operating characteristic curve(ROC) and area under curve (AUC) used logistic regressive model.Results The leukocyte count in control group,SIM-IO group,peritonitis group,and STR-IO group were (6.97 ± 1.68) × 109/L,(8.24 ± 2.78) × 109/L,(11.33 ±4.75) × 109/L,and(12.53 ± 5.96) × 109/L respectively.STR-IO group and peritonitis group were significantly higher than those of control group(F =12.74,P =0.01),but there was no significant difference between SIM-IO group and control group(P ＞ 0.05).The concentration of plasma D-dimer in control group,SIM-IO group,peritonitis group,and STR-IO group were (0.44± 0.30) μg/ml,(1.17 ± 0.67) μg/ml,(1.20 ± 0.72) μg/ml,and (1.67 ± 0.67) μg/ml respectively.The concentration of D-dimer in STR-IO group was significantly higher than those of control group (F =57.08,P =0.00),and there was no significant difference among other group (P ＞ 0.05).The concentration of serum HDC in control group,SIM-IO group,peritonitis group,and STR-IO group were (5.51 ±4.30) ng/ml,(14.33 ± 3.71) ng/ml,(11.53 ± 4.67) ng/ml,and (35.65 ± 21.15) ng/ml respectively.The concentration of HDC in STR-IO group was significantly higher than those of other three groups (F =39.03,P =0.00).The concentration of serum I-FABP in control group,SIM-IO group,peritonitis group,and STR-IO group were (0.20 ± 0.06) ng/m],(0.31 ± 0.17) ng/ml,(0.22 ±0.03)ng/ml,and (0.81 ±0.56) ng/ml respectively.The concentration of I-FABP in STR-IO group was significantly higher than those of other three groups (F =23.07,P =0.01).The AUC of HDC,I-FABP,D-dimer,and leukocyte count were 0.998,0.868,0.730,and 0.704 respactively.Conclusion Leukocyte count,D-dimer,and HDC or I-FABP combined detection may be a more effective index for diagnosing acute intestinal obstruction.

Chronic pharyngitis is a common disease,there's dispute in its treatments. It expounds the availability of moxibustion on chronic pharyngitis and puts forwards the doubt of efficacy of inducing fire to the origin of TDP magic lamp and moxibusiton from aspects of mechanism and present treatments.

AIM: To investigate the effects of propofol, midazolam and thiopental sodium on neurologic and histologic outcome from focal cerebral ischemia-reperfusion in a rat model of reversible middle cerebral artery occlusion (MCAO). 　METHODS: Male SD rats were scheduled to undergo 3 h MCAO by intraluminal suture and 24 h reperfusion. Neurologic outcome was scored with a 0-5 grading scale. Infarct volume was shown with TTC staining and measured by image analysis system. Ultrastructure of the tissues taken from the brim of the damaged area was examined under electron microscope. 　RESULTS: Both propofol and midazolam could attenuate neurologic deficits, reduce infarct and edema volumes, and ameliorate ultrastructure damage at the brim of lesion. Propofol showed better neuroprotection than midazolam while thiopental sodium did not exhibit protective effect.　CONCLUSION: Propofol and midazolam, but not thiopental sodium, can provide protective effects against reperfusion induced injury in rats subjected to focal cerebral ischemia.