Objective To construct the training program for the digital and intelligent capabilities of specialized nurses in the Central Sterile Supply Department(CSSD),and conduct preliminary practice to provide talent support for the intelligent development of CSSD.Methods From February to April 2024,based on the core technologies of digital intelligence and related core capabilities,a training program for digital intelligence-related competencies of CSSD specialized nurses was constructed using literature review and the Delphi expert consultation method.From July to August 2024,the program was initially implemented in the training of CSSD specialized nurses.The nurses'information competency before and after the training was compared,and the nurses' satisfaction with the digital intelligence-related training program was assessed.Results This study conducted 2 rounds of expert consultation via questionnaire.The effective recovery rate of the questionnaires in both rounds was 100％.The expert authority coefficients were 0.790 and 0.800,respectively,and the variation coefficients ranged from 0 to 0.229 and 0 to 0.105.Ultimately,a training program for the digital-related competencies of CSSD specialty nurses was established,which includes 4 components:training objectives,training content,training methods,and assessment methods.Specifically,there were 3 indicators at the first level and 14 at the second level for training objectives,6 indicators at the first level and 32 at the second level for training content,and 6 indicators at the first level for training methods and assessment methods.After the implementation of the training program,the information competency of the nurses in all dimensions and the total score were significantly higher than those before training(P＜0.05).Moreover,the average scores for the training content,training methods,and assessment methods were all above 3 points,indicating a high overall satisfaction among the nurses.Conclusion The construction process of the training program for the digital and intelligent capabilities of CSSD specialty nurses is scientific and reliable.The content is highly practical and distinctive in its specialty.The training methods and assessment approaches are diverse.This program can enhance nurses' information competency and provide a reference for the implementation of digital and intelligent training for CSSD specialty nurses.

Objective To investigate the current status of cleaning,disinfection,and sterilization management of dental instruments in medical institutions in Henan Province,analyze potential issues in hospital infection control,and propose targeted nursing strategies.Methods A convenience sampling method was used to survey the cleaning,disinfection,and sterilization management of dental instruments in 352 medical institutions in Henan Province from February to April 2024.A self-made questionnaire was designed,covering aspects such as the handling model and personnel configuration for dental instruments,training for cleaning,disinfection,and sterilization personnel,configuration and maintenance of cleaning and disinfection equipment,use and management of small pressure steam sterilizers,and reprocessing status of dental instruments.Results A total of 352 questionnaires were distributed,with 348 valid responses.Among the 34 primary medical institutions,only 10(29.41％)had a centralized cleaning,disinfection,and sterilization model for dental instruments;13(38.24％)had dedicated personnel for cleaning,disinfection,and sterilization of dental instruments;25(73.53％)were equipped with pressure water guns.Compari-sons among medical institutions of different levels showed statistically significant differences(P＜0.001).In the 348 medical institutions,194(55.75％)arranged pre-job training for nursing personnel;143(41.09％)performed mainte-nance on cleaning and disinfection equipment once a year;52(14.94％)did not perform pre-treatment on contaminated dental instruments after use.Among the 104 institutions using small pressure steam sterilizers,21(20.19％)used Type N small pressure steam sterilizers.Conclusion The centralized management rate of dental instruments and the basic equipment configuration rate in primary medical institutions in Henan Province are relatively low.There are issues such as insufficient personnel training,neglect of equipment maintenance,improper management of small pressure steam sterilizer usage,and incomplete reprocessing procedures in medical institutions at all levels.It is recommended that nursing managers further strengthen the training of nurses in the disinfection supply center,standardize the cleaning,disinfection,and sterilization workflow for dental instruments,in order to prevent and control hospital infections.

Objective To investigate the current status of cleaning,disinfection,and sterilization management of dental instruments in medical institutions in Henan Province,analyze potential issues in hospital infection control,and propose targeted nursing strategies.Methods A convenience sampling method was used to survey the cleaning,disinfection,and sterilization management of dental instruments in 352 medical institutions in Henan Province from February to April 2024.A self-made questionnaire was designed,covering aspects such as the handling model and personnel configuration for dental instruments,training for cleaning,disinfection,and sterilization personnel,configuration and maintenance of cleaning and disinfection equipment,use and management of small pressure steam sterilizers,and reprocessing status of dental instruments.Results A total of 352 questionnaires were distributed,with 348 valid responses.Among the 34 primary medical institutions,only 10(29.41％)had a centralized cleaning,disinfection,and sterilization model for dental instruments;13(38.24％)had dedicated personnel for cleaning,disinfection,and sterilization of dental instruments;25(73.53％)were equipped with pressure water guns.Compari-sons among medical institutions of different levels showed statistically significant differences(P＜0.001).In the 348 medical institutions,194(55.75％)arranged pre-job training for nursing personnel;143(41.09％)performed mainte-nance on cleaning and disinfection equipment once a year;52(14.94％)did not perform pre-treatment on contaminated dental instruments after use.Among the 104 institutions using small pressure steam sterilizers,21(20.19％)used Type N small pressure steam sterilizers.Conclusion The centralized management rate of dental instruments and the basic equipment configuration rate in primary medical institutions in Henan Province are relatively low.There are issues such as insufficient personnel training,neglect of equipment maintenance,improper management of small pressure steam sterilizer usage,and incomplete reprocessing procedures in medical institutions at all levels.It is recommended that nursing managers further strengthen the training of nurses in the disinfection supply center,standardize the cleaning,disinfection,and sterilization workflow for dental instruments,in order to prevent and control hospital infections.

Objective To construct the training program for the digital and intelligent capabilities of specialized nurses in the Central Sterile Supply Department(CSSD),and conduct preliminary practice to provide talent support for the intelligent development of CSSD.Methods From February to April 2024,based on the core technologies of digital intelligence and related core capabilities,a training program for digital intelligence-related competencies of CSSD specialized nurses was constructed using literature review and the Delphi expert consultation method.From July to August 2024,the program was initially implemented in the training of CSSD specialized nurses.The nurses'information competency before and after the training was compared,and the nurses' satisfaction with the digital intelligence-related training program was assessed.Results This study conducted 2 rounds of expert consultation via questionnaire.The effective recovery rate of the questionnaires in both rounds was 100％.The expert authority coefficients were 0.790 and 0.800,respectively,and the variation coefficients ranged from 0 to 0.229 and 0 to 0.105.Ultimately,a training program for the digital-related competencies of CSSD specialty nurses was established,which includes 4 components:training objectives,training content,training methods,and assessment methods.Specifically,there were 3 indicators at the first level and 14 at the second level for training objectives,6 indicators at the first level and 32 at the second level for training content,and 6 indicators at the first level for training methods and assessment methods.After the implementation of the training program,the information competency of the nurses in all dimensions and the total score were significantly higher than those before training(P＜0.05).Moreover,the average scores for the training content,training methods,and assessment methods were all above 3 points,indicating a high overall satisfaction among the nurses.Conclusion The construction process of the training program for the digital and intelligent capabilities of CSSD specialty nurses is scientific and reliable.The content is highly practical and distinctive in its specialty.The training methods and assessment approaches are diverse.This program can enhance nurses' information competency and provide a reference for the implementation of digital and intelligent training for CSSD specialty nurses.

AMP-activated protein kinase (AMPK) is a widely distributed and evolutionarily conserved serine/threonine protein kinase present in eukaryotic cells. In regulating cellular energy metabolism, AMPK plays an extremely important role as an energy metabolic kinase. When the body is in a low energy state, AMPK is activated in response to changes in intracellular adenine nucleotide levels and is bound to adenosine monophosphate (AMP) or adenosine diphosphate (ADP). Activated AMPK regulates various metabolic processes, including lipid and glucose metabolism and cellular autophagy. AMPK directly promotes autophagy by phosphorylating autophagy-related proteins in the mammalian target of rapamycin complex 1 (mTORC1), serine/threonine protein kinase-dysregulated 51-like kinase 1 (ULK1) and type Ⅲ phosphatidylinositol 3-kinase-vacuolar protein-sorting 34 (PIK3C3-VPS34) complexes. AMPK also indirectly promotes autophagy by regulating the expression of downstream autophagy-related genes of transcription factors such as forkhead box O3 (FOXO3), lysosomal function transcription factor EB (TFEB) and bromodomain protein 4 (BRD4). AMPK also regulates mitochondrial autophagy, induces the division of damaged mitochondria and promotes the transfer of the autophagic response to damaged mitochondria. Another function of AMPK is to regulate mitochondrial health by stimulating mitochondrial biogenesis and participating in various aspects of mitochondrial homeostasis regulation. This review discusses the specific regulation of mitochondrial biology and internal environmental homeostasis by AMPK signaling channels as central to the cellular response to energy stress and regulation of mitochondria, highlighting the key role of AMPK in regulating cellular autophagy and mitochondrial autophagy, as well as advances in research on the regulation of mitochondrial homeostasis.

With the continuous development of surgery,the amount of Da Vinci robot surgery has increased year by year,and Da Vinci robot has been widely used in the field of surgery.However,due to its structural characteristics,robot surgical instruments are difficult to clean after contamination,which poses a great challenge to the cleaning technology of nurses in central sterile supply department(CSSD).At present,there are still some problems in the cleaning quality management of Da Vinci robotic surgical instruments,such as inadequate pre-treatment,non-standard manual cleaning process,and inconsistent cleaning quality evaluation methods,which bring great hidden dangers to patients'medical safety.Therefore,scientific and effective cleaning quality control is very important to prevent nosocomial infection and ensure the life safety of patients.This paper reviews the cleaning process and quality control on Da Vinci robotic surgical instruments by consulting,screening,sorting and summarizing domestic and foreign relevant literature of the cleaning and management,and combining with the actual clinical work of the disinfection supply center,and aims to provide theoretical references for the formulation of guidelines and clinical practice for the personnel of CSSD.

Objective:To explore whether the lipopolysaccharide (LPS)-induced modification of O-linked N-acetylglucosamine (O-GlcNAc) is involved in the inflammatory signaling pathway of endothelial cells.Methods:Human umbilical vein endothelial cells (HUVEC) were cultured in vitro, and cells in logarithmic growth phase were used for experiments. Cells were divided into blank control group, LPS group (2 000 mg/L LPS), O-GlcNAc transferase (OGT) overexpression (OGT-OE)+LPS group (plasmid transfection OGT+2 000 mg/L LPS), protein kinase C (PKC) inhibitor+LPS group (10 μmol/L Go 6983+2 000 mg/L LPS), RhoA inhibitor+LPS group (40 μmol/L Rhoin hydrochloride+2 000 mg/L LPS), phosphatidylinositol-3-kinase (PI3K) inhibitor+LPS group (1 μmol/L SL-2052+2 000 mg/L LPS), serine/threonine kinase (Akt) inhibitor+LPS group (10 μmol/L PP2+2 000 mg/L LPS) and small interfering RNA (siRNA) treated Akt (si-AKT)+LPS group (si-Akt+2 000 mg/L LPS). After 24 hours of LPS treatment, real-time fluorescence quantitative reverse transcription-polymerase chain reaction (RT-qPCR) was used to detect the transcription levels of inflammatory cytokines [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1)]. The protein expression or phosphorylation of OGT, O-GlcNAc, Akt, extracellular signal-regulated kinase (ERK), p38 mitogen-activated protein kinase (p38MAPK), nuclear factor-κB p65 (NF-κB p65), and signal transducer and activator of transcription 3 (STAT3) were determined by Western blotting. Results:Compared with the blank control group, the expression of OGT and the modification of O-GlcNAc in the LPS group were decreased, while the expressions of phosphorylated ERK, p38MAPK, and STAT3 were increased, and the transcript levels of inflammatory cytokines were also significantly increased [IL-6 mRNA (2 -ΔΔCt): 4.71±0.60 vs. 1.03±0.29, TNF-α mRNA (2 -ΔΔCt): 1.89±0.11 vs. 1.04±0.35, ICAM-1 mRNA (2 -ΔΔCt): 2.06±0.18 vs. 1.02±0.21, VCAM-1 mRNA (2 -ΔΔCt): 2.94±0.57 vs. 1.01±0.17, all P < 0.05], indicating that LPS could decrease O-GlcNAc modification, activate inflammatory signaling pathways and increase inflammatory cytokines expression. Compared with the LPS group, the expressions of phosphorylated ERK, p38MAPK, NF-κB p65, and STAT3 in the endothelial cells of the OGT-OE+LPS group were decreased, and the expression of inflammatory factors were significantly decreased [IL-6 mRNA (2 -ΔΔCt): 0.12±0.01 vs. 0.90±0.17, TNF-α mRNA (2 -ΔΔCt): 0.31±0.01 vs. 0.91±0.14, ICAM-1 mRNA (2 -ΔΔCt): 0.64±0.02 vs. 1.13±0.16, VCAM-1 mRNA (2 -ΔΔCt): 0.11±0.01 vs. 0.93±0.11, all P < 0.05], indicating that the increase of OGT level could inhibit the partial activation of the endothelial inflammatory signal pathway under the LPS stimulation. Compared with the blank control group, the phosphorylation level of Akt in the LPS group was increased. Compared with the LPS group, both OGT expression and O-GlcNAc modification were down-regulated after pretreatment of PKC inhibitor, RhoA inhibitor, PI3K inhibitor, or Akt inhibitor. Compared with the LPS group, the transcript levels of IL-6, TNF-α and ICAM-1 in the PP2+LPS group were significantly decreased [IL-6 mRNA (2 -ΔΔCt): 1.46±0.16 vs. 3.55±0.87, TNF-α mRNA (2 -ΔΔCt): 0.98±0.14 vs. 1.76±0.10, ICAM-1 mRNA (2 -ΔΔCt): 1.39±0.24 vs. 2.04±0.13, all P < 0.05], but there was no significant change in VCAM-1. Compared with the LPS group, the expression of OGT and O-GlcNAc modification in the si-Akt+LPS group were decreased, while the transcript levels of inflammatory cytokines were also significantly decreased [IL-6 mRNA (2 -ΔΔCt): 0.75±0.03 vs. 0.99±0.09, TNF-α mRNA (2 -ΔΔCt): 0.69±0.01 vs. 1.10±0.08, ICAM-1 mRNA (2 -ΔΔCt): 0.76±0.01 vs. 0.99±0.02, VCAM-1 mRNA (2 -ΔΔCt): 0.93±0.08 vs. 1.20±0.21, all P < 0.05], indicating that Akt participated in the action process of LPS on OGT and affected the inflammatory factor expression. Conclusions:The decreased level of O-GlcNAc modification in endothelial cells stimulated with LPS promotes partial activation of inflammatory signaling pathways, mainly involving ERK, p38MAPK, and STAT3, and affects the expression of inflammatory factors. AKT may be involved in the effect of LPS on the inhibition of O-GlcNAc modification.

OBJECTIVE: To explore the correlation of plasma N-acetyl-neuraminic acid level with Thrombolysis In Myocardial Infarction (TIMI) risk score and clinical outcomes of patients with acute coronary syndrome (ACS). METHODS: We consecutively enrolled 708 consecutive patients (401 male and 307 female, mean age 63.6±10.6 years) undergoing coronary angiography in our hospital between October, 2018 and July, 2019, including 597 patients with ACS and 111 without ACS (control group). The patients with ACS group were divided into high (=104), moderate (=425) and low (=68) risk groups according to their TIMI risk scores. All the participants were examined for plasma Neu5Ac level using liquid chromatography-tandem mass spectrometry and underwent coronary angiography with their Gensini scores calculated. The patients with ACS were followed up after discharge for a mean of 15 months for the occurrence of major adverse cardiac events (Mace). Binary logistic regression analysis was performed to identify the risk factors of Mace in these patients. RESULTS: Plasma Neu5Ac levels were significantly higher in ACS group than in the control group ( < 0.05). ROC curve analysis showed that plasma Neu5Ac level could assist in the diagnosis of ACS (0.648 [0.597-0.699]) with a sensitivity of 39.2% and a specificity of 86.5% at the cutoff value of 288.50 ng/mL. In the ACS patients, plasma Neu5Ac level was significantly higher in the high-risk group than in the moderate-risk and low-risk groups ( < 0.05) and could assist in the diagnosis of a high risk (0.645 [0.588-0.703]) with a sensitivity of 42.3% and a specificity of 80.1% at the cutoff value of 327.50 ng/ mL. Plasma Neu5Ac was positively correlated with age, serum uric acid, creatinine, lipoprotein a, Ddimer, C-reactive protein, MB isoform of creatine kinase and Gensini score and negatively correlated with high-density lipoprotein level. During the followup, 80 ACS patients experienced Mace, who had significantly higher plasma Neu5Ac level than those without Mace (=517). Logistic regression analysis showed that plasma Neu5Ac level and a history of previous stroke were independent risk factors for the occurrence of Mace. CONCLUSIONS Plasma Neu5Ac level can provide assistance in the diagnosis and risk stratification of ACS and is an independent risk factor for prognosis of ACS patients.

Objective: To explore the plasma level change of soluble tumor necrosis factor related apoptosis inducing ligand (sTRAIL) in patients with systemic lupus erythematosus (SLE) and its clinical significance. Methods: Quantitative real-time reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the mRNA expressions of TRAIL and TRAIL receptors-1 (TRAIL-R1) and TRAIL-R2 in the peripheral blood mononuclear cells (PBMCs) derived from active SLE patients (n=26) and healthy controls. Enzyme linked immuno sorbent assay (ELISA) was used to detect the plasma level of sTRAIL in the active SLE patients (n=42), healthy controls (n=21). Pearson correlation analysis was used to analyze the correlation of sTRAIL with clinical and laboratory parameters. Results: The plasma levels of sTRAIL [(82±5) pg/ml] in SLE were significantly higher than that in healthy controls [(49±3) pg/ml], the difference was statistically significant (t=4.10, P<0.01). The plasma levels of sTRAIL in SLE with inactive disease [(92±14) pg/ml], mild active disease [(80±9) pg/ml], moderate active disease [(74±12) pg/ml] and severe active disease [(83±8) pg/ml] were higher than healthy controls, the difference was statistically significant (H=18.07, P<0.01). The mRNA levels of TRAIL and TRAIL-R2 in PBMCs derived from SLE patients were significantly higher than those in healthy controls [(1.04±0.08) vs (1.80±0.25), t=2.10, P<0.05 and (1.07±0.12) vs (2.08±0.21), t=3.27, P<0.01]. In SLE with moderate and severe active disease, plasma sTRAIL levels were associated with the 24 hours urine protein. Conclusion Plasma sTRAIL may be predictors of SLE disease activity and TRAIL pathway may be a new potential target of SLE treatment.

Objective The purpose of this study is to observe the changes of immune cell subsets in lupus mice after umbilical cord mesenchymal stem cells (UC-MSCs) transplantation. Methods B6.MRL-Faslpr lupus mice were randomly divided into the following three groups: the UC-MSCs treated group, the fibroblast like synoviocytes (FLS) treated group and the untreated group. MSC (1×106) or FLS (1×106) were injected into the tail vein of lupus mice respectively. Four weeks after treatment, the spleen index was calculated. The pathological changes of kidney were assessed by HE staining. The frequencies of immune cell subsets in spleen and macrophage in kidney as well as abdominal cavity were analyzed by flow cytometry. Data were analyzed with t test. Results The spleen index of UC-MSCs treated lupus mice [(79 ±9) mg/10 g] and IgG level [(7.5±1.5) mg/ml] were significantly decreased when compared with FLS treated group [(147±23) mg/10 g, t=2.78, P<0.01] [(17.0 ±2.8) mg/ml, t=3.00, P<0.01] and the untreated group [(156 ±16) mg/10 g, t=4.29, P<0.01] [(16.7 ±1.6) mg/ml,t=4.01, P<0.01]. HE staining also showed that the pathological changes of kidney were alleviated after MSCs transplantation. In addition, the frequency of plasma cells in the untreated group [(2.61 2± 0.318)% vs (0.306±0.017)%, t=7.22, P<0.01] and the FLS treated group [(2.412±0.297)% vs (0.306±0.017)%, t=7.07, P<0.01] were markedly higher than MSCs treatment [(0.306 ±0.017)%]. Moreover, the frequency of CD25+Foxp3+/CD4+Treg in the MSCs treated group [(15.08±0.81)%] was significantly increased compared with the untreated group [(8.02 ±0.47)%, t=7.45, P<0.01] and FLS treated group [(8.80 ±0.23)%, t=7.39, P<0.01]. MSCs treatment resulted in a decrease in CXCR5+PD1+/CD4+Tfh and IFNγ+/CD4+Th1 subset, compared with the untreated group [(14.3±1.5)%vs (31.5±3.3)%, t=5.25, P<0.01] [(1.78±0.27)% vs (5.93±1.56)%, t=2.60, P<0.05] and the FLS treated group [(14.3±1.5)%vs (28.8±2.2)%, t=5.49, P<0.01] [(1.78±0.27)%vs (4.88±0.81)%, t=3.61, P<0.01]. The frequency of macrophage in kidney of the MSCs treated group [(3.52 ±0.37)%] was markedly increased compared with the untreated group[(1.58±0.29)%, t=3.25, P<0.01], while neither the IL4+/CD4+Th2 subset nor the IL17+/CD4+Th17subset and the frequency of macrophage in abdominal cavity showed significant changes in the three groups. Conclusion These findings suggest that the therapeutic effects of MSCs on lupus mice may mediate through increasing the frequency of spleen Treg and renal macrophage and decreasing the frequency of Tfh, Th1 and plasma cells.