Objective To analyze the correct answering rate and factors affecting healthcare-associated infection(HAI)test questions among medical interns,and provide reference for formulating teaching plans.Methods All medical interns who participated in pre-job training and testing on HAI in a hospital from October 2020 to February 2024 were selected.Pre-internship training and in-class testing on HAI were conducted.After the internship ended,a class of students was randomly selected each year to directly take the written test using the same set of questions.The impact of test content,question types,majors,educational background,and the epidemic on the correct an-swering rate of pre-internship test was analyzed,and correct answering rate for tests before and after internships was compared.Results A total of 1 163 interns were assessed,out of which 48.75％obtained a correct answering rate of 90％-100％for test questions before the internship.Among the 10 test contents,the correct answering rates for questions about multidrug-resistant organism infection prevention and control were the lowest([67.13±34.35]％),among 3 types of questions,the correct answering rate for indefinite-choice questions was the lowest([79.80±19.31]％).The correct answering rates of interns majoring in clinical medicine([90.49±12.32]％)and nursing([87.54±10.73]％)were higher than those of other majors([82.80±12.24]％).The correct an-swering rate of undergraduate students([89.05±11.29]％)was higher than that of junior college student([83.77±12.26]％).The correct answering rate of interns during the epidemic period([87.51±11.48]％)was higher than that after the epidemic([79.85±13.98]％),and the correct answering rate after the internship([81.89±14.78]％)decreased compared with that before the internship([92.99±10.48]％).Differences were all statistically signifi-cant(all P＜0.005).Conclusion Teachers can carry out targeted teaching plan reforms based on the factors affect-ing the correct answering rate(such as different majors,teaching content,and internship periods)to improve teach-ing quality.

Objective To analyze the correct answering rate and factors affecting healthcare-associated infection(HAI)test questions among medical interns,and provide reference for formulating teaching plans.Methods All medical interns who participated in pre-job training and testing on HAI in a hospital from October 2020 to February 2024 were selected.Pre-internship training and in-class testing on HAI were conducted.After the internship ended,a class of students was randomly selected each year to directly take the written test using the same set of questions.The impact of test content,question types,majors,educational background,and the epidemic on the correct an-swering rate of pre-internship test was analyzed,and correct answering rate for tests before and after internships was compared.Results A total of 1 163 interns were assessed,out of which 48.75％obtained a correct answering rate of 90％-100％for test questions before the internship.Among the 10 test contents,the correct answering rates for questions about multidrug-resistant organism infection prevention and control were the lowest([67.13±34.35]％),among 3 types of questions,the correct answering rate for indefinite-choice questions was the lowest([79.80±19.31]％).The correct answering rates of interns majoring in clinical medicine([90.49±12.32]％)and nursing([87.54±10.73]％)were higher than those of other majors([82.80±12.24]％).The correct an-swering rate of undergraduate students([89.05±11.29]％)was higher than that of junior college student([83.77±12.26]％).The correct answering rate of interns during the epidemic period([87.51±11.48]％)was higher than that after the epidemic([79.85±13.98]％),and the correct answering rate after the internship([81.89±14.78]％)decreased compared with that before the internship([92.99±10.48]％).Differences were all statistically signifi-cant(all P＜0.005).Conclusion Teachers can carry out targeted teaching plan reforms based on the factors affect-ing the correct answering rate(such as different majors,teaching content,and internship periods)to improve teach-ing quality.

Objective:To systematically analyze and integrate the real experience of puerpera in free delivery positions.Methods:Qualitative or mixed method studies on attitudes and emotional experiences of puerpera towards free delivery positions were retrieved through computer on PubMed, ScienceDirect, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, and WanFang Data. The search period was from database establishment to November 30, 2022. The quality of literature was evaluated using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center in Australia. The aggregation integration method was used to integrate the results.Results:A total of 5 articles were included and 28 results were extracted. The results were summarized into 10 categories, and 3 integrated results were formed, including factors that affected the choice of delivery position, the complex delivery experience of the puerpera, and the hope for much support.Conclusions:Hospitals, communities, and families should fully understand women's emotional experiences and needs for free delivery positions, provide sufficient support and guidance, and provide a reference basis for developing a reasonable delivery position plan and promoting a positive delivery experience.

Chloral hydrate is a safe and effective sedative hypnotic medicine. Patients can usually calm down or fall asleep quickly after taking it. It has great clinical value and practical needs in children ’s sedation. However ，the nature of chloral hydrate itself and various factors such as ambient temperature and light affect its stability of the preparation ，most of chloral hydrate preparations are still used in clinic in the form of hospital preparations. Therefore ，developing chloral hydrate preparation with single dose ，long validity period and automatic mass production is the prospect and goal of its subsequent development. Based on it，this study collects and reviews the relevant literatures on various preparations of chloral hydrate and their clinical application by searching the Chinese and English databases.

OBJECTIVE： To establish the method for simultaneous determination of 4 kinds of flavones such as sutellarin， sutellarein， luteolin and apigenin in Scutellaria barbata decoction pieces， and to conduct principle component analysis. METHODS： HPLC method was adopted. The determination was performed on Agilent ZOXDB-C18 column with mobile phase consisted of methanol-acetonitrile （80 ∶ 20，V/V）-1％ acetic acid solution （gradient elution） at the flow rate of 1.0 mL/min. The detection wavelength was set at 335 nm， and column temperature was 30 ℃. The sample size was 10 μL. Principal component analysis was carried out by SPSS 20.0 and SIMCA-P 13.0 software. RESULTS： The linear ranges of sutellarin， sutellarein， luteolin and apigenin were 0.131-1.446 μg（r＝0.999 0）， 0.031-0.345 μg（r＝0.999 7）， 0.005-0.055 μg（r＝0.999 2）， 0.024-0.268 μg（r＝0.999 2）， respectively. The limits of quantitation were 1.178 8， 0.602 9， 0.744 1， 1.079 1 ng； the limits of detection were 0.353 6， 0.106 1， 0.223 2， 0.323 7 ng；RSDs of precision， stability and reproducibility tests were all lower than 2％. The recoveries were 99.38％-100.56％（RSD＝0.44％，n＝6）， 91.01％-96.81％（RSD＝2.43％， n＝6）， 91.44％-97.34％（RSD＝2.59％， n＝6）， 96.21％- 99.26％（RSD＝1.23％，n＝6）， respectively. By principal component analysis， principal component 1 and prinicipal component 2 were main influential factors of sample， quality accumulative variance contribution rate of them was 92.573％（＞80％）. The comprehensive score of sample S14-3 was the highest， and the overall quality was relatively good； samples S14-2， S14-3 were the second. These 3 batches of sample were processed and produced in S. barbata planting base with stable quality. CONCLUSIONS： Established method is simple and rapid， and can be used for simultaneous determination of 4 kinds of flavones in S. barbata decoction pieces. Principle component analysis can provide reference for the quality control of S. barbata decoction pieces.

Objective To explore the impact of healthcare-associated septicemia (HAS)on hospitalization expense as well as length of hospital stay,so as to optimize the allocation of healthcare resources,and provide scientific basis for reducing the economic burden caused by septicemia.Methods Hospitalized patients with confirmed HAS in a tertiary first-class teaching hospital between June 1 ,2012 and May 31 ,2015 were investigated retrospectively,con-trol group was set up in a 1 :1 ratio,hospitalization expense and length of hospital stay between two groups were compared.Results A total of 285 cases and 285 controls were enrolled in the study,the median of hospitalization expense in case group was higher than control group (￥19 718.39 vs ￥9 289.04,P <0.05);the median of length of hospital stay in case group was longer than control group (14.89 days vs 9.22 days,P <0.05).The disease bur-den caused by septicemia in different age groups and departments were different.The improvement rate of case group was lower than control group (76.49% [218/285 ]vs 83.51 % [238/285 ],χ2 = 2.562,P = 0.009 ). Conclusion As the common blood stream infection in hospitalized patients,septicemia not only increased the ex-pense of diagnosis and treatment,but also affected turnover rate of hospital bed.Rapid and effective diagnosis and treatment is significant o prevent and control septicemia.

OBJECTIVETo induce Mycobacterium tuberculosis (MTB) resistance with ofloxacin (Ofx) of stepwise increasing concentration in vitro, investigate stability to fluoroquinolone (FQs) antibiotic of MTB, and analyze the molecular mechanism and mutation specialty of drug resistance preliminarily.

METHODSMTB Standard strain H37RV and 24 clinical isolates susceptible to Ofx were selected and experimentally serially subcultured in liquid culture medium containing increasing concentration of Ofx and induced the drug resistance to Ofx. Variety of Minimal Inhibitory Concentrations (MICs) to FQs drugs were detected by microwell-MIC-test method. Mutations of quinolone resistance determining region (QRDR) of gyrA gene were sequenced and identified. Relationship of different mutation sites and drug resistant degree were analyzed. A total of 6 MTB clinical isolates resistant to Ofx and induced drug resistant isolates in vitro were serially subcultured in liquid culture medium without drug. Variety of drug resistant stability, including MIC and mutation of gyrA gene were detected.

RESULTSMIC values of 21 Ofx susceptible isolates after induction were eight times higher than before, which were induced to drug resistant strains successfully and also resistant to Lfx and Mfx. Hot mutations of QRDR of gyrA gene were detected by sequencing, except one strain. Mutation of codon 94 occurred in 60% (12/20) of the strains with mutations and corresponding value of 50% Minimal Inhibitory Concentrations(MIC50) was ≥ 8 µg/ml. In all, 4 of 6 MTB clinical isolates resistant to Ofx harbored mutation of codon 90 (67%) , but the corresponding value of MIC50 was 2 µg/ml. After 21 serially subcultured in liquid culture medium without drug, MIC values of 6 clinical isolates resistant to Ofx were not changed obviously and mutations were also not changed. After 11 times serially subcultured in culture medium without drug, MIC values of induced drug resistant strains were also not changed obviously, but new mutations were detected in QRDR of 3 isolates.

CONCLUSIONMTB strains resistant to three kinds of FQs antibiotic were obtained by induction in vitro with Ofx. Codons 88, 94 mutations of QRDR of gyrA gene were related to the high level FQs drug resistance of MTB. Drug resistant stability of MTB to FQs was strong, and it is difficult for MTB to resume susceptibility.

Antitubercular Agents ; pharmacology ; DNA Gyrase ; genetics ; Drug Resistance, Bacterial ; genetics ; Microbial Sensitivity Tests ; Mycobacterium tuberculosis ; drug effects ; genetics ; isolation & purification ; Ofloxacin ; pharmacology

Objective To investigate mutations in immediate early ( IE) gene ORF62 of three var-icella vaccine Oka strains ( vOka ) including two strains produced in China and their parental Oka strain (pOka), and then to further elucidate its possible roles in attenuation mechanism by comparing their ORF 62 promoter sequences and its activities , ORF62 coding regions and its transactivities .Methods ORF62 pro-moter-reporter plasmids and ORF62-expressing plasmids of pOka and three vOka strains ( vOka-BK from Changchun BCHT Biotechnology Co ., vOka-SH from Shanghai Institute of Biological Product Co .Ltd., and vOka-GSK from GlaxoSmithKline plc, as control) were constructed, respectively.ORF62 promoter regions and coding regions of the four strains were sequenced and then compared with each other .Differences of ac-tivities of the ORF62 promoter, and transactivities of the ORF62-encoded IE62 upon immediate early (ORF4), early (ORF28) and late (ORF67) gene promoters between pOka and vOka strains were assayed with transient transfection technique .Results Compared with pOka strain , three vOka strains had a con-sistent T deletion mutation at site 110 050 in ORF62 promoters, which did not result in any change of tran-scription factor binding motif .However , activities of ORF62 promoters from three vOka strains were signifi-cantly lower than those of pOka strain .Three consistent substitution mutations were observed in ORF 62 cod-ing regions of three vOka strains and three new enzyme restriction sites including SmaⅠ, NaeⅠand BssHⅡwere generated, respectively.Transactivities of IE62 from three vOka strains upon ORF4, ORF28 and ORF67 promoters were significantly higher than those of pOka both in CV-1 and MeWo cells , except that vOka-SH IE62 showed significantly lower transactivities upon ORF 4 promoter than those of pOka strain in CV-1 cells.Conclusion Consistent T deletion mutation at site 110 050 in ORF62 promoters of three vOka strains might be responsible for the reduced promoter activities and the changes of IE 62 transactivities .How-ever , it seemed that cell types have no significant effect on ORF 62 promoter activity or IE 62 transactivity be-tween pOka and vOka strains .

Objective To further investigate inhibitory mechanism(s) of resveratrol on varicellazoster virus (VZV) in vitro with our previously generated reporter cell line MV9G.Methods Cell-free VZVs were directly inoculated onto MV9G cells (CFVs direct-infection) or cell-associated VZVs wereco-cultured with MV9G cells (CAVs co-culture) to activate expression of reporter gene firefly luciferase in MV9G cells.Resveratrol was added before or after virus infection,roles of resveratrolon direct inactivation,on viral attachment to and penetration into MV9G cells,on intracellular viral replication and its IC50,inhibitorytime points and reversibility were assayed by comparing the luciferase activities reduction by resveratrol.Thereductions of VZV IE62 mRNA copies and IE62-antibody positive cells by resveratrol were further assayed.Results ATPs contents of MV9G cells in the presence of resveratrol over 30.0 μg/ml were concentrationdependently reduced,the CD50 of which was around 60.3 μg/ml.CFVs were premixed with 25.0 μg/ml resveratrol andincubated at 37℃ waterbath for two hours and then directly inoculated onto MV9G cells,luciferases activated by resveratrol-treated CFVs were reduced to around half of the untreated controls.MV9G cells were pre-incubated with resveratrol at 37℃ for 2 h and then directly infected with CFVs at 37℃ for another 2 h,the CFVs-activated luciferase was concentration-dependently reduced,but no big change was observed in those pre-incubated at 4℃.MV9G cells were co-cultured with CAVs in the presence of resvertrolfor 72 h,the CAVs-activated luciferases were markedly reduced in a concentration-dependent manner,the IC50 of which was around 8.7 μgml.Resveratrol was added in CAVs co-culture at 1,3,6,9,12,24,30,and 36 h post infection,the CAVs-activated luciferase in those resveratrol was added at 3,6,9,12,and 24 h post infection were significantly higher than those of controls.Resveratrol was withdrawn from CAVs coculture media,the CAVs-activated luciferases after withdrawal were significantly higher than those before,especially in those withdrswn at 24 and 72 h post infection.The IE62 mRNA levels shown by cDNA copiesdetected with SYBR Green RT-PCR and IE62 positive cells shown by monoclonal anti-IE62 antibody of thevirus-infected cells treated with resveratrol were significantly reduced with increase of incubation time withresveratrol.Conclusion Resveratrol was cytotoxic to MV9G cells,and the maximum resistant concentrationon MV9G cells was around 30.0 μg/ml,the CD50 of which was around 60.3 μg/ml.Non-cytotoxic resveratrol partly inactivated CFVs,inhibited viral penetration into rather than attachment to MV9G cells.Resveratrol inhibited CAVs' intmcellular replication strongly but reversibly in a concentration-dependent manner,the IC50 of which was around 8.7 μ/ml.The inhibition of resveratrol on VZV in vitro might be through suppression of IE62 gene transcription and expression in the early stage of infection.

Objective To establish a novel method to screen for anti-varicella-zoster virus (VZV) compounds with our previously generated reporter cell line for VZV, MV9G. MethodsMV9G cells were directly infected with cell-free virus of Oka vaccine strain (vOka) for 2 hours( CFV direct-infection) or cocultured with vOka-infected MeWo cells containing cell-associated virus for 48 hours (CAV co-culture) to promote expression of the reporter gene firefly luciferase. Antiviral compounds including heparin, mannose-6-phosphate( M-6-P), acyclovir( ACV ), resveratrol and roscovitine were added in the medium before or after the virus infection. Inhibitory effects( IC50 ) of the antiviral compounds were analyzed by comparing firefly luciferase activities of MV9G cells in the presence of antiviral compounds with those in the absence. Results Antiviral compounds inhibited luciferase activities of MV9G cells activated by CFV direct-infection and/or CAV co-culture in different levels. The reductions of luciferase activities statistically correlated with those of viral foci shown by immunostaining with a monoclonal antibody against VZV immediate early 62 antigens (IE62) in controls. Among these compounds, heparin, M-6-P, and 2.5 μmol/L of roscovitine inhibited CFV-activated more strongly than CAV-activated luciferase activities, whereas ACV and resveratrol inhibited CAV-activated more strongly than CFV-activated luciferase activities. Cell-associated ACV-resistant strains,Kanno and rOka YSR, activated luciferase activities of MV9G cells, too. However, the inhibitory concentrations (IC50) of ACV to the ACV-resistant strains were much higher than those to the ACV-sensitive strains,pOka and CaGu. ConclusionThe CFV direct-infection and CAV co-culture assays were useful to screen for antiviral compounds targeting the early and late phases of VZV infection, respectively. The VZV reporter cell-based assays may provide a simple, rapid, sensitive, and high-throughput method to screen for anti-VZV compounds.