1.Effects of astragalus angelica on apoptosis and expression of Bax and caspase-3/9 in rabbit chondrocytes after fresh osteochondral allograft
Wan-Tao DONG ; Pan YANG ; Xiu-Juan YANG ; Shi-Ming QIU ; Peng YUAN ; Jing-Yi LIU ; Jiu-Mei HUANG ; Yu ZHOU
Chinese Pharmacological Bulletin 2024;40(12):2288-2294
Aim To observe the effect of Astragalus membranaceus and Angelica sinensis on the apoptosis of chondrocytes,and to investigate the effect of Astrag-alus membranaceus and Angelica sinensis on the sur-vival of fresh ostecartilage allograft.Methods Forty-eight 4-month-old New Zealand white rabbits,half male and half female,were randomly divided into sham operation group,model group,positive group and As-tragalus and Angelica 5∶1 group.In addition to the sham operation group,the other groups were both male and female donors and recipients for knee joint osteo-cartilage cross transplantation modeling.After 8 weeks of drug intervention,samples were taken for general observation,HE staining,saffrane-O staining,immu-nohistochemical staining,qPCR and Western blot de-tection.Results Compared with model group,As-tragalus and Angelica 5∶1 group and positive group,the repair site healed better,the morphology of osteo-chondrocytes tended to be normal,and the division and proliferation were obvious.Proteoglycan deposition in-creased and type Ⅱ collagen content was higher,the differences were statistically significant(P<0.05).qPCR and Western blot results showed that compared with model group,the mRNA and protein expressions of Bax,caspase-3 and caspase-9 in other groups were significantly decreased(P<0.05).Conclusion As-tragalus and Angelica can promote the survival of fresh osteochondral allograft,and its mechanism may be re-lated to promoting collagen production,promoting chondrocyte proliferation and inhibiting chondrocyte apoptosis.
2.Changes of coagulation function before and after neoadjuvant chemotherapy in patients with ovarian cancer and their clinical significance
Wan SHI ; Yaxing YANG ; Chu CHEN ; Miao WANG ; Yongfeng WANG ; Xin WEI ; Fang LEI
China Pharmacist 2024;27(5):802-809
Objective To investigate the changes of coagulation,fibrinolysis and platelet indexes in ovarian cancer patients before and after neoadjuvant chemotherapy,and to analyze the risk relationship between relevant indexes before treatment and the effect of neoadjuvant chemotherapy(NACT).Methods Patients with ovarian cancer admitted to Xi'an Fengcheng Hospital,from March 2020 to March 2023 were included as the ovarian cancer group,and female patients who underwent physical examination in the same period were selected as the control group according to a 2∶1 ratio.Prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),fibrinogen(FIB),platelet distribution width(PDW),platelet hematocrit(PCT),platelet(PLT)and mean platelet volume(MPV)were compared between the two groups.The changes of these indexes were compared before and after NACT,at different clinical stages and before and after NACT with different efficacy effects.Moreover,they were divided into effective and ineffective groups according to their treatment efficacy.Logistic regression was used to explore the relationship between the parameters and NACT efficacy;receiver operating characteristic curve was drawn to predict the value of NACT efficacy.Results A total of 144 patients were included,with 96 cases in the ovarian cancer group and 48 in the control group.The FIB,PLT and MPV of patients in the ovarian cancer group were higher than those in the control group(P<0.05).The PT,TT,APTT,FIB and PLT of ovarian cancer patients after NACT were lower than those before NACT(P<0.05).FIB and PLT of stage Ⅱ patients were lower than those of stage Ⅲ before and after NACT,and the PT,TT,APTT,FIB and PLT of the effective group were lower than those of the ineffective group before and after NACT,and the PT,TT,APTT,FIB and PLT of the two groups after NACT were lower than those before NACT(P<0.05).Multivariate Logistic regression analysis indicated that high PT,TT,APTT,FIB and PLT before NACT were independent risk factors for NACT ineffectiveness(P<0.05).The area under the curve of PT,TT,APTT,FIB and PLT before NACT to predict the effect of NACT were 0.713(sensitivity of 80.95%,specificity of 69.33%),0.756(sensitivity of 71.43%,specificity of 82.67%)and 0.787(sensitivity of 76.19%,specificity of 70.67%),0.727(sensitivity of 71.43%,specificity of 84.00%),0.794(sensitivity of 80.95%,specificity of 76.00%),respectively.Conclusion Changes in coagulation and fibrinolytic function and platelet parameters in ovarian cancer patients after NACT are associated with clinical stages and NACT effect.High levels of PT,TT,APTT,FIB and PLT before NACT are important reasons affecting NACT effect.Constructing the risk prediction model of NACT efficacy in ovarian cancer patients based on the above five parameters can provide a reference for clinical practice.
3.Effect of usnic acid on malignant behavior of gastric cancer cells investigated based on CCL2-CCR2 signal axis
Xiaoli TENG ; Zhaohong SHI ; Qingbin MENG ; Xiaoli ZHOU ; Yan LIAO ; Ying WAN ; Jian YANG
Chinese Journal of Immunology 2024;40(8):1665-1670
Objective:To investigate impacts of usnic acid(UA)on malignant behavior of gastric cancer cells by regulating the chemokine(C-C motif)ligand 2(CCL2)-CCL2 receptor(CCR2)signal axis.Methods:SGC-7901 cells,a well growing human gastric cancer cell line,were treated with different concentrations of UA,which were grouped into low concentration(UA-L)group(62.5 μmol/L UA),medium concentration(UA-M)group(125 μmol/L UA)and high concentration(UA-H)group(250 μmol/L UA);meantime,the cells were transfected with CCL2 overexpression vector(pc DNA3.1 CCL2),empty vector(pc DNA3.1),silenced CCL2(si CCL2)and negative control(si control),and SGC-7901 cells were treated with 250 μmol/L UA,labeled as UA-H+pc DNA3.1 CCL2 group,UA-H+pc DNA3.1 group,UA-H+si control group and UA-H+si CCL2 group,another untreated SGC-7901 cells were taken as the control group.Flow cytometry,MTT and qRT-PCR were applied to detect cell apoptosis,proliferation,and expres-sion levels of CCL2 and CCR2 mRNA;Western blot was applied to detect expression levels of PD-L1,apoptotic protein(Bax),proli-ferative protein(CyclinD1,CCL2,CCR2)and immune escape related protein(B7H1);after co-culturing with CD8+T cells isolated and cultured in vitro,ELISA was applied to detect levels of IL-4,IFN-γ and IL-10 in the supernatant.Gastric cancer cells in each group were co-cultured with activated peripheral blood mononuclear cell(PBMC)1∶1 for 72 hours,and the sensitivity of gastric can-cer cells in each group to T-cell-mediated killing was compared.Results:Compared with control group,cell proliferation rate,IL-10 level,CyclinD1,PD-L1,CCL2,CCR2 and B7H1 protein and mRNA expressions,cell counts after co-culturing with activated PBMC 1∶1 for 72 hours in UA-L group,UA-M group and UA-H group were obviously reduced,while apoptosis rate,IL-4 and IFN-γ levels,Bax protein expression were obviously increased(P<0.05);compared with UA-H+pc DNA3.1 group,cell proliferation rate,IL-10 level,CyclinD1,PD-L1,CCL2,CCR2 protein and mRNA expressions,cell counts after co-culturing with activated PBMC 1∶1 for 72 hours in UA-H+pc DNA3.1 CCL2 group were obviously increased,while apoptosis rate,IL-4 and IFN-γ levels,and Bax protein ex-pression were obviously reduced(P<0.05);compared with UA-H+si control group,cell proliferation rate,IL-10 level,CyclinD1,PD-L1,CCL2,CCR2 and B7H1 protein and mRNA expressions,cell counts after co-culturing with activated PBMC 1∶1 for 72 hours in UA-H+si CCL2 group were obviously reduced,while apoptosis rate,IL-4 and IFN-γ levels and Bax protein expression were obviously increased(P<0.05).Conclusion:UA can inhibit gastric cancer cells proliferation,immune escape,and induce apoptosis,which may be related to the inhibition of the CCL2-CCR2 signaling axis.
4.Dynamic evaluation of inflammation in infarct area after acute myocardial infarction and its relationship with left ventricular remodeling by 18F-FDG PET imaging
Feifei ZHANG ; Xiaoliang SHAO ; Jianfeng WANG ; Xiaoyu YANG ; Min XU ; Peng WAN ; Shengdeng FAN ; Yunmei SHI ; Wenji YU ; Bao LIU ; Xiaoxia LI ; Xiaoyun WANG ; Baosheng MENG ; Yong WANG ; Yuetao WANG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2024;44(11):661-667
Objective:To evaluate inflammation early in the infarct zone and its dynamic changes after acute myocardial infarction (AMI) using 18F-FDG PET imaging, and analyze its relationship with left ventricular remodeling progression (LVRP). Methods:Sixteen Bama miniature pigs (4-6 months old, 8 females) were selected. AMI models were established by balloon occlusion of the left anterior descending artery. 18F-FDG PET imaging was performed before AMI and at days 1, 5, 8, and 14 post-AMI to evaluate the regional inflammation response. 18F-FDG SUV ratio (SUVR) and the percentage of uptake area of left ventricle (F-extent) in the infarct zone, and the SUVRs of the spleen and bone marrow, were measured. Echocardiography and 99Tc m-methoxyisobutylisonitrile(MIBI) SPECT myocardial perfusion imaging (MPI) were performed at the above time points and on day 28 post-AMI to assess left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF), and myocardial perfusion defect extent. The degree of LVRP at day 28 post-AMI was defined as ΔLVESV(%)=(LVESV AMI 28 d-LVESV AMI 1 d)/LVESV AMI 1 d×100%. Data were analyzed using repeated measures analysis of variance, Kruskal-Wallis rank sum test and Pearson correlation analysis. Results:Twelve pigs were successfully modeled and completed the study. Inflammation in the infarct zone persisted until day 14 post-AMI. The SUVR of the infarct zone pre-AMI and at days 1, 5, 8, and 14 post-AMI were 1.03±0.08, 3.49±1.06, 2.93±0.90, 2.38±0.76, and 1.63±0.62, respectively ( F=49.31, P<0.001). The F-extent values in the infarct zone pre-AMI and at days 1, 5, 8, and 14 post-AMI were 0, (40.08±12.46)%, (40.00±12.76)%, (31.08±12.82)%, and 16.50%(7.25%, 22.00%), respectively ( H=37.61, P=0.001). There were no significant differences in the SUVRs of bone marrow and spleen before and after AMI ( F values: 0.69 and 0.77, both P>0.05). At day 1 post-AMI, both SUVR and F-extent in the infarct zone were significantly correlated with LVRP ( r values: 0.82 and 0.70, P values: 0.001 and 0.035). Conclusions:18F-FDG PET imaging can be used to evaluate inflammation in the infarct area and its dynamic changes after AMI. Inflammation in the infarct area is severe at day 1, and then gradually decreases. The extent and severity of inflammation visible on 18F-FDG PET imaging 1 d after AMI are closely related to LVRP.
5.A multicenter study of neonatal stroke in Shenzhen,China
Li-Xiu SHI ; Jin-Xing FENG ; Yan-Fang WEI ; Xin-Ru LU ; Yu-Xi ZHANG ; Lin-Ying YANG ; Sheng-Nan HE ; Pei-Juan CHEN ; Jing HAN ; Cheng CHEN ; Hui-Ying TU ; Zhang-Bin YU ; Jin-Jie HUANG ; Shu-Juan ZENG ; Wan-Ling CHEN ; Ying LIU ; Yan-Ping GUO ; Jiao-Yu MAO ; Xiao-Dong LI ; Qian-Shen ZHANG ; Zhi-Li XIE ; Mei-Ying HUANG ; Kun-Shan YAN ; Er-Ya YING ; Jun CHEN ; Yan-Rong WANG ; Ya-Ping LIU ; Bo SONG ; Hua-Yan LIU ; Xiao-Dong XIAO ; Hong TANG ; Yu-Na WANG ; Yin-Sha CAI ; Qi LONG ; Han-Qiang XU ; Hui-Zhan WANG ; Qian SUN ; Fang HAN ; Rui-Biao ZHANG ; Chuan-Zhong YANG ; Lei DOU ; Hui-Ju SHI ; Rui WANG ; Ping JIANG ; Shenzhen Neonatal Data Network
Chinese Journal of Contemporary Pediatrics 2024;26(5):450-455
Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75%(27/36);boys accounted for 64%(23/36).Among the 36 neonates,31(86%)had disease onset within 3 days after birth,and 19(53%)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61%)had left cerebral infarction and 13(36%)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75%)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72%)and seizures in 10 neonates(34%).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33%,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44%(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.
6.Discussion on the Mechanism of Fire Needle in Treating Knee Osteoarthritis Based on p38MAPK Signaling Pathway
Tian WAN ; Yang XIAO ; Xinyue SHI ; Kunda HONG
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(8):70-75
Objective To explore the mechanism of fire needle in treating cartilage degeneration in knee osteoarthritis(KOA)based on p38MAPK signaling pathway.Methods Totally 30 SPF grade male SD rats were randomly divided into blank group,model group and fire needle group,with 10 rats in each group.The model group and fire needle group established KOA models by injecting papain into the knee joint cavity.The fire needle group received fire needle intervention in"Neixiyan"and"Dubi",while the model group and blank group only received fixation and no intervention,once every 3 days,for 4 consecutive weeks.Morphological changes in the knee joint cartilage were observed using HE staining and safranine O-solid green staining,TUNEL staining was used to detect the apoptosis index of chondrocytes,immunohistochemical staining was used to detect the expressions of p-p38 and Fas protein,qPCR was used to detect the expressions of p38 and Fas mRNA.Results Compared with the blank group,the surface of the knee joint cartilage in the model group rats was uneven,with irregular and uneven arrangement of chondrocytes,lighter matrix red staining,and unclear tidal lines,the improved Mankin's score significantly increased(P<0.001),the apoptosis index of chondrocytes significantly increased(P<0.01),the expressions of p-p38 and Fas protein in knee joint cartilage tissue significantly increased(P<0.01),and the expressions of p38 and Fas mRNA significantly increased(P<0.001).Compared with the model group,the surface of the knee joint cartilage of the fire needle group rats was relatively flat,the arrangement of chondrocytes was generally normal,and the matrix staining was slightly lighter,the improved Mankin's score significantly decreased(P<0.001),the apoptosis index of chondrocytes significantly decreased(P<0.01),the expressions of p-p38 and Fas protein in knee joint cartilage tissue significantly decreased(P<0.01),and the expressions of p38 and Fas mRNA significantly decreased(P<0.001).Conclusion Fire needle may delay the progression of KOA by inhibiting the activation of p38MAPK signaling pathway and reducing chondrocyte apoptosis of knee joint.
7.Biological effects of acute high-dose radon exposure on mice
Pengcheng GU ; Gengsheng SHI ; Jianfang HAN ; Jiliang YANG ; Xiangkun REN ; Na CHEN ; Jun WAN ; Liang SUN ; Fengmei CUI ; Yu TU
Chinese Journal of Radiological Medicine and Protection 2024;44(8):645-649
Objective:To investigate the biological effects of acute high-dose radon exposure on mice.Methods:BALB/c male mice aged 6 to 8 weeks were exposed once in an HD-3 ecological radon chamber with an average radon concentration of 7 × 10 5 Bq/m 3 for 10 h. Mice were weighed, their lung tissues and blood samples were collected at 1, 2 and 3 months after exposure. Control groups were set up at the three time points with four mice in each group. For these mice, the lung tissue pathology was observed using hematoxylin-eosin (HE) staining method, routine blood tests were conducted using a hematology analyzer and the levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in the serum and lung tissues were measured using corresponding assay kits. Results:The HE staining result revealed that compared to the control groups, the experimental groups exhibited thickening of alveolar walls and increased infiltration of granulocyte, whose degrees, however, reduced over time and displayed no significant difference at 3 months after exposure. There was no significant difference in body weight or blood routine between the experimental and control groups. The detection result revealed decreased SOD levels in the lung tissues at 2 months after exposure, which were (11.34 ± 1.03) U/mgprot and (9.75 ± 0.71) U/mgprot, respectively for the control and experimental groups ( t = 2.54, P < 0.05). The MDA levels in lung tissue increased at 1 month after exposure, which were(2.30 ± 0.24) and (2.77 ± 0.29) nmol/mgprot, respectively for the control and experimental groups ( t = 2.49, P < 0.05). At 3 months after exposure, the SOD and MDA levels differed insignificantly between the control and experimental groups ( P > 0.05). Conclusions:After acute high-dose radon exposure, the mice suffered damage to the lung tissue, with changes in their oxidative stress indicators being detected. However, these effects gradually diminished at 3 months after exposure. Additionally, acute high-dose radon exposure did not give rise to significant changes in the body weight or routine blood result of the mice.
8.Premature death of female breast cancer patients and its trend in Putuo District of Shanghai from 2004 to 2019
Feiya SHI ; Jun CHEN ; Lijuan YANG ; Wan WANG ; Yuan SHEN
Shanghai Journal of Preventive Medicine 2024;36(7):701-705
ObjectiveTo understand the incidence and death of female breast cancer patients and the premature death caused by breast cancer in Putuo District of Shanghai, and to reduce the incidence of breast cancer, mortality and the probability of early death, and to provide reference for realizing the control target of the probability of early death of major chronic diseases. MethodsThe incidence and death data of the registered female residents with breast cancer in Putuo District of Shanghai from 2004 to 2019 were collected using Shanghai Population-based tumor registration management system. The crude incidence rate, standardized incidence rate, crude mortality rate, standardized mortality rate, age-specific incidence rate, age-specific mortality rate and other indicators were calculated. The Joinpoint regression model was used to calculate the annual percentage change (APC) and average annual percentage change (AAPC) of breast cancer incidence, mortality and premature death probability, and to analyze the changing trend. ResultsFrom 2004 to 2019, the crude incidence of breast cancer in Putuo District of Shanghai increased from 75.76/105 to 95.77/105 (APC=2.26%, t=6.05, P<0.01), while the standardized incidence did not decrease significantly during 2004‒2008 (APC=-4.83%, t=-1.81, P=0.10) and showed an upward trend after 2008 (APC=1.67%, t=2.84, P=0.02). The crude mortality rate changed from 18.52 per 105 to 21.63 per 105 (APC= 1.51%, t=1.52, P=0.15), and the standardized mortality rate decreased from 9.91/105 to 7.44/105 (APC=-1.46%, t=-2.43, P=0.03). The incidence rate in the group of 30‒69 years increased from 98.39/105 to 111.75/105 (APC=1.14%, t=3.05, P=0.01), and the mortality rate increased from 16.13/105 to 19.30/105 (APC=0.48%, t=0.84, P=0.41). The incidence rate of patients aged ≥70 years varied from 165.68/105 to 139.53/105 (APC=1.54%, t=1.25, P=0.23), and the mortality rate changed from 85.08/105 to 56.64/105 (APC=-0.18%, t=-0.08, P=0.94). The probability of premature death from breast cancer decreased from 7.73‰ to 6.61‰ (APC=-1.56%, t=-2.30, P=0.04). ConclusionThe risk of female breast cancer morbidity and death can not be ignored, and the control pressure of premature death probability is still large. Attention should be paid to the age group of 30‒69 years old, and further measures should be taken to control the increase of incidence and to reduce mortality, so as to reduce the probability of premature death of female breast cancer, and promote the realization of the overall control goal of premature death probability.
9.Effects and Mechanisms of Electroacupuncture at Zhongwan (CV12) on Gastric Nociceptive Response Induced by Gastric Acid Stimulation in Rats
Hong SHI ; Zhaokun YANG ; Xiaoyu WANG ; Wei HE ; Yangshuai SU ; Xiaoning ZHANG ; Hongye WAN ; Zhengyang QU ; Xianghong JING
Journal of Traditional Chinese Medicine 2024;65(2):213-218
ObjectiveTo observe the effects of electroacupuncture at Zhongwan (CV12) on gastric nociceptive response induced by gastric acid stimulation and explore the underlying mechanisms associated with nuclei of the medullary viscerosensory and visceral motor neurons. MethodsTwenty SD rats were given intragastric administration of 0.5 mol/L diluted hydrochloric acid (0.5 ml/100 g) to induce gastric nociceptive response induction. Eight rats were randomly selected to record the gastric slow wave (GSW) area under the curve, and extracellular discharge frequency of neurons in the nucleus of the solitary tract (NTS) and dorsal motor nucleus of the vagus nerve (DMV) before intragastric administration and at 1, 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, and 60 minutes after intragastric administration. The remaining 12 rats received electroacupuncture intervention at Zhongwan within 5 to 25 minutes after intragastric administration of diluted hydrochloric acid, with a duration of one minute. The GSW area under the curve and extracellular discharge frequency of NTS and DMV neurons were compared between the 1-minute intervals before and after electroacupuncture intervention. ResultsCompared to the baseline before intragastric administration, the area under the curve of GSW significantly increased at 1, 5, 10, 15, 20, and 25 minutes after intragastric administration, and the extracellular discharge frequency of excitatory neurons in the NTS (accounting for 90%, 57/63) significantly increased at 1, 5, 10, 15, 20, 25, 30, 35, and 40 minutes, both reaching peak values at 1 minute after intragastric administration (P<0.01 or P<0.05). The extracellular discharge frequency of inhibitory neurons in the DMV (accounting for 91%, 20/22) showed a non-significant increase at 1 minute after intragastric administration (P>0.05), but significantly decreased at other timepoints (P<0.05). Compared to the baseline before electroacupuncture intervention, the GSW area under the curve and the extracellular discharge frequency of excitatory neurons in the NTS significantly decreased (P<0.05), while the extracellular discharge frequency of inhibitory neurons in the DMV showed no significant difference (P>0.05). ConclusionElectroacupuncture at Zhongwan can improve gastric nociceptive response induced by gastric acid stimulation, possibly by reducing the transmission of visceral sensation and decreasing the excitability of NTS neurons in the medulla.
10.The experience on the construction of the cluster prevention and control system for COVID-19 infection in designated hospitals during the period of "Category B infectious disease treated as Category A"
Wanjie YANG ; Xianduo LIU ; Ximo WANG ; Weiguo XU ; Lei ZHANG ; Qiang FU ; Jiming YANG ; Jing QIAN ; Fuyu ZHANG ; Li TIAN ; Wenlong ZHANG ; Yu ZHANG ; Zheng CHEN ; Shifeng SHAO ; Xiang WANG ; Li GENG ; Yi REN ; Ying WANG ; Lixia SHI ; Zhen WAN ; Yi XIE ; Yuanyuan LIU ; Weili YU ; Jing HAN ; Li LIU ; Huan ZHU ; Zijiang YU ; Hongyang LIU ; Shimei WANG
Chinese Critical Care Medicine 2024;36(2):195-201
The COVID-19 epidemic has spread to the whole world for three years and has had a serious impact on human life, health and economic activities. China's epidemic prevention and control has gone through the following stages: emergency unconventional stage, emergency normalization stage, and the transitional stage from the emergency normalization to the "Category B infectious disease treated as Category B" normalization, and achieved a major and decisive victory. The designated hospitals for prevention and control of COVID-19 epidemic in Tianjin has successfully completed its tasks in all stages of epidemic prevention and control, and has accumulated valuable experience. This article summarizes the experience of constructing a hospital infection prevention and control system during the "Category B infectious disease treated as Category A" period in designated hospital. The experience is summarized as the "Cluster" hospital infection prevention and control system, namely "three rings" outside, middle and inside, "three districts" of green, orange and red, "three things" before, during and after the event, "two-day pre-purification" and "two-director system", and "one zone" management. In emergency situations, we adopt a simplified version of the cluster hospital infection prevention and control system. In emergency situations, a simplified version of the "Cluster" hospital infection prevention and control system can be adopted. This system has the following characteristics: firstly, the system emphasizes the characteristics of "cluster" and the overall management of key measures to avoid any shortcomings. The second, it emphasizes the transformation of infection control concepts to maximize the safety of medical services through infection control. The third, it emphasizes the optimization of the process. The prevention and control measures should be comprehensive and focused, while also preventing excessive use. The measures emphasize the use of the least resources to achieve the best infection control effect. The fourth, it emphasizes the quality control work of infection control, pays attention to the importance of the process, and advocates the concept of "system slimming, process fattening". Fifthly, it emphasizes that the future development depends on artificial intelligence, in order to improve the quality and efficiency of prevention and control to the greatest extent. Sixth, hospitals need to strengthen continuous training and retraining. We utilize diverse training methods, including artificial intelligence, to ensure that infection control policies and procedures are simple. We have established an evaluation and feedback mechanism to ensure that medical personnel are in an emergency state at all times.

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