Objective To investigate the pathogenic bacteria and risk factors of urinary tract infection (UTI) in elderly patients with type 2 diabetic mellitus (T2DM), and construct a prediction model. Methods Elderly patients with T2DM who were admitted to General Hospital of Western Theater Command from January 2020 to March 2023 were selected. They were divided into the observation group (100 cases) and the control group (82 cases) according to the presence or absence of UTI. Pathogenic bacteria was detected, and influencing factors were analyzed. A prediction model was constructed, and its predictive value was evaluated. Results Escherichia coli was the main pathogenic bacteria of UTI in elderly patients with T2DM. There were significant differences between the two groups in terms of age, 24 h urinary albumin (UALB), serum creatinine (Scr) , blood urea nitrogen (BUN), fasting blood glucose (FBG), gender, complications, course of T2DM , length of hospital stay and serum albumin (ALB) (P<0.05). Logistic regression analysis found that advanced age, long course of T2DM, FBG ≥11.1mmol/L and high 24 hUA1b/Scr level were risk factors for UTI in elderly patients with T2DM, and high ALB level was a protective factor. The receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of the constructed model to predict UTI in patients with T2DM was 0.978. The sensitivity and specificity were 91.00% and 97.56%. Conclusion Escherichia coli are main pathogenic bacteria of UTI in elderly patients with T2DM. UTI is related to factors such as patient age, course of T2DM and FBG. The prediction model constructed based on these factors is of high value in predicting UTI in elderly patients with T2DM. It is worthy of promotion in diagnosis and treatment.

On June 16, 2023, National Disease Control and Prevention Administration of the People’s Republic of China, in collaboration with other ministries, formulated and issued the Action Plan to Accelerate the Elimination of Schistosomiasis in China (2023—2030). The implementation of this plan provides an important basis for achieving the targets set in the “Healthy China 2030” action plan and the implementation of the rural revitalization strategy. This paper describes the background, principles, targets, control strategies, safeguard measures and effectiveness evaluation of the plan, in order to guide the scientific and standardized implementation of actions for schistosomiasis elimination at the grassroots level, and facilitate the progress towards elimination of schistosomiasis in China with a high quality.

Objective A typical case survey and elemental analysis of the implementation of Antimicrobial Steward-ship(AMS)in a medical institution in Shanghai,summarize the excellent experience of AMS in practice,and pro-vide a reference for the further promotion and implementation of AMS in the future.Methods Through purposive sam-pling,7 typical hospitals in Shanghai were selected as sampling hospitals,and key informed persons of AMS were invited to conduct semi-structured interviews.Based on the core elements of AMS theory,it conducted subject analysis to summarize the implementation and excellent practical experience of AMS in hospitals.Results The sample hospitals are excellent in the AMS elements of leadership and accountability,but need to be further strengthened in training,tracking and reporting.On the basis of routine bundle of interventions,some hospitals actively explored and expanded AMS actions according to their own disciplinary advantages.Combined with a series of internal and ex-ternal control measures,AMS strategy with the characteristics of hospitals has been formed,and the related indica-tors of antibiotics in hospitals have been improved.Conclusion In the follow-up process of AMS,hospitals can draw on excellent experience,carry out the appropriate AMS strategy on the basis of consolidating their own governance structure and routine interventions.Besides,relevant departments should increase investment in AMS information systems and human resources in hospitals to ensure the implementation of AMS.

Objective:To explore the characteristics of renal oxidative stress injuries in rats with high-voltage electric burns and the intervention effects of breviscapine.Methods:This study was an experimental study. One hundred and sixty 8-10-week-old male Sprague Dawley rats were divided into sham injury group, electric burn group, saline group, low breviscapine group, middle breviscapine group, and high breviscapine group, with 60 rats in each of the sham injury group and electric burn group, 10 rats in each of the other 4 groups, respectively. The rats in sham injury group and electric burn group were divided into 10 rats at each time point, including post injury hour (PIH) 0 (immediately), 8, 24, 48, and 72, and post injury week (PIW) 1. The rats in sham injury group were not conducted with electrical current to cause sham injury. The rats in the other 5 groups were caused high-voltage electric burns. The rats in sham injury group and electric burn group were not treated after injury. The rats in saline group, low breviscapine group, middle breviscapine group, and high breviscapine group were intraperitoneally injected with 5 mL/kg normal saline or 0.4, 1.6, and 4.0 g/L breviscapine, repeated every 24 h until PIH 72. After the model was successfully made, 14 rats died, including 1, 2, 2, and 1 rat (s) at PIH 24, 48, and 72 and PIW 1 in electric burn group, 4, 1, 2, and 1 rat (s) at PIH 72 in saline group, low breviscapine group, middle breviscapine group, and high breviscapine group, respectively. The kidney tissue collected from rats in the 6 groups was weighed and the kidney/body weight ratio was calculated. The left upper pole tissue of kidney was collected from each 4 rats in sham injury group, and in electric burn group at PIH 8, 24, 48, and 72 and PIW 1, and in saline group, low breviscapine group, middle breviscapine group, and high breviscapine group at PIH 72. The renal tubular and renal interstitial injury was evaluated by a semi-quantitative histological scoring system after hematoxylin-eosin staining. The inferior vena cava blood samples were collected from rats in the 6 groups to measure the serum creatinine levels via sarcosine oxidase method, and serum urea nitrogen levels via urease method. The right renal cortices were collected from rats in the 6 groups to measure the catalase (CAT) activity in the supernatant of renal tissue via molybdic acid method, and the levels of advanced oxidation protein product (AOPP) and Klotho protein in the supernatant of renal tissue via enzyme-linked immunosorbent assay.Results:At PIH 8, 48, and 72 and PIW 1, the kidney/body weight ratios of rats in electric burn group were significantly higher than those in sham injury group (with t values of -0.52, -3.75, -4.05, and -2.25, respectively, P<0.05). At PIH 72, compared with those in electric burn group, saline group, low breviscapine group, and middle breviscapine group, the kidney/body weight ratio of rats in high breviscapine group was significantly decreased (with P values all <0.05). Compared with those in sham injury group, the renal tubular and renal interstitial injury scores of rats in electric burn group at PIH 48 and 72 and PIW 1 were significantly increased ( P<0.05). Compared with those in electric burn group at PIH 8 and 24, the renal tubular and renal interstitial injury score of rats in electric burn group at PIW 1 was significantly increased (with P values all <0.05). At PIH 72, the renal tubular and renal interstitial injury scores of rats in the 5 groups of rats with electric burns were similar ( P>0.05). At PIH 8, 24, 48, and 72 and PIW 1, the levels of serum creatinine and serum urea nitrogen of rats in electric burn group were significantly higher than those in sham injury group (with Z values of -2.00, -2.37, -2.62, -2.67, -3.67, -2.34, -3.11, -3.43, -3.11, and -3.51, respectively, P<0.05). Compared with that in electric burn group at PIH 0, the levels of serum creatinine of rats in electric burn group at PIH 72 and PIW 1 were significantly increased ( P<0.05). Compared with that in electric burn group at PIH 8, the levels of serum creatinine of rats in electric burn group at PIH 72 and PIW 1 were significantly increased ( P<0.05). Compared with that in electric burn group at PIH 24, the level of serum creatinine of rats in electric burn group at PIW 1 was significantly increased ( P<0.05). At PIH 72, the levels of serum creatinine of rats in the 5 groups of rats with electric burns were similar ( P>0.05). Compared with that in electric burn group, the levels of serum urea nitrogen of rats in low breviscapine group, middle breviscapine group, and high breviscapine group were significantly decreased ( P<0.05). Compared with that in saline group, the levels of serum urea nitrogen in middle breviscapine group and high breviscapine group were significantly decreased ( P<0.05). At PIH 48 and 72 and PIW 1, the CAT activities in the supernatant of renal tissue of rats in electric burn group were significantly lower than those in sham injury group (with Z values of -2.22, -2.13, and -3.51, respectively, P<0.05). At PIH 8, 24, 48, and 72 and PIW 1, the levels of AOPP in the supernatant of renal tissue of rats in electric burn group were significantly higher than those in sham injury group (with Z values of -2.00, -3.15, -2.71, -2.04, and -2.33, respectively, P<0.05). At PIH 0-PIW 1, the levels of Klotho protein in the supernatant of renal tissue of rats in sham injury group and electric burn group were all similar ( P>0.05). Compared with that in electric burn group at PIH 0, the CAT activities in the supernatant of renal tissue of rats in electric burn group at PIH 72 and PIW 1 and the levels of Klotho protein in the supernatant of renal tissue of rats in electric burn group at PIH 48 and 72 and PIW 1 were significantly decreased ( P<0.05). Compared with that in electric burn group at PIH 8, the CAT activities in the supernatant of renal tissue of rats in electric burn group at PIH 72 and PIW 1 and the levels of Klotho protein in the supernatant of renal tissue of rats in electric burn group at PIH 48 and 72 and PIW 1 were significantly decreased ( P<0.05). Compared with that in electric burn group at PIH 24, the CAT activities in the supernatant of renal tissue of rats in electric burn group at PIH 72 and PIW 1 were significantly decreased ( P<0.05). Compared with that in electric burn group at PIH 48, the CAT activity in the supernatant of renal tissue of rats in electric burn group at PIW 1 was significantly decreased ( P<0.05). At PIH 72, the levels of Klotho protein in the supernatant of renal tissue of rats in the 5 groups of rats with electric burns were similar ( P<0.05). Compared with 14.6 (12.6, 23.6) U/mgprot in electric burn group, the CAT activities in the supernatant of renal tissue of rats in low breviscapine group (20.5 (18.0, 39.8) U/mgprot), middle breviscapine group (24.9 (14.7, 28.9) U/mgprot), and high breviscapine group (28.0 (21.9, 39.1) U/mgprot) were significantly increased ( P<0.05). Compared with 15.7 (13.7, 25.6) U/mgprot in saline group, the CAT activities in the supernatant of renal tissue of rats in middle breviscapine group and high breviscapine group were significantly increased ( P<0.05). Compared with that in low breviscapine group, the CAT activity in the supernatant of renal tissue of rats in high breviscapine group was significantly increased ( P<0.05). Compared with those in electric burn group and saline group, the levels of AOPP in the supernatant of renal tissue of rats in middle breviscapine group and high breviscapine group were significantly decreased ( P<0.05). Conclusions:After high-voltage electric burns, oxidative stress injury occur in the kidneys of rats, which is aggravated with time extension. Breviscapine can alleviate oxidative stress injuries in the kidneys of rats with high-voltage electric burns.

Objective To investigate the clinical value of intermittent oral-to-esophageal tube feeding combined with perioral massage in treating dysphagia of children with Pierre Robin Syndrome (PRS). Methods A total of 92 PRS children with mandibular distraction osteogenesis were selected and divided into observation group and control group by stratified randomization, with 46 cases in each group. The control group received continuous nasal tube feeding intervention, while the observation group received intermittent oral-to-esophageal tube feeding combined with perioral massage intervention. The changes in nutritional status[body mass index (BMI), serum hemoglobin (Hb), total protein (TP), albumin (ALB)] before and after 1 month of intervention were compared between the two groups. The clinical indicators (hospital stay, time to start oral feeding, and time to full gastrointestinal feeding) were also compared 1 month after the intervention. The swallowing conditions and incidence of complications were recorded in both groups. Results After 1 month of intervention, BMI, Hb, TP and ALB in both groups significantly increased, and the observation group had significant higher values in BMI of (21.58±1.26) kg/m², Hb of (118.76±10.36) g/L, TP of (55.28±6.74) g/L, ALB of (33.46±4.37) g/L compared to BMI of (20.30±1.22) kg/m², Hb of (112.74±9.46) g/L, TP of (51.68±6.33) g/L and ALB of (30.59±4.68) g/L in the control group (P < 0.05). In the observation group, the feeding time was (32.26±4.43) minutes, hospital stay was (21.48±3.11) days, time to start oral feeding was (14.26±3.16) days, and time to full gastrointestinal feeding was (16.79±2.32) days, which were significantly shorter than (36.79±4.65) min, (24.39±3.31) days, (17.25±3.24) days, and (20.48±3.29) days respectively in the control group (P < 0.05); the average residual feeding volume was (10.26±2.18) mL and the number of cases with milk flow was 8 (17.39%) in the observation group, which were significantly less than (12.79±2.31) mL and 17 (36.95%) in the control group (P < 0.05). Conclusion Intermittent oral-to-esophageal tube feeding combined with perioral massage can effectively improve swallowing difficulty in children with PRS and shorten the hospital stay.

Objective: To investigate the daily learning time status of elementary school students and understand the implementation of Health Requirements of Daily Learning Time for Secondary and Elementary School Students (GB/T 17223-2012) in schools, so as to provide a reference for strengthening and improving school health and health education in the new era. Methods: A stratified cluster random sampling method was used to select 7 776 primary school students in Shandong Province, and a survey questionnaire was designed based on the Health Requirements for Dayily Learning Time for Secondary and Elementary School Students(GB/T 17223-2012) standard to investigate their daily learning arrangements, sleep and physical activities, and breaks between classes. Comparison of intergroup differences were used by Chi square test and Kruskal-Wallis H test. Results: About 55.88 % of primary school students for daily learning time met the standard. There was a statistically significant difference in the daily learning time achievement rate among primary school students in three grades for first and second grade, third and fourth grade and fifth and sixth grade ( Z=1 629.47, P <0.01), and the fifth and sixth grade had the highest proportion of achieving the standard (85.92%). Specifically, the proportions of students whose class hours, class numbers and morning reading time meeting the standards were 30.07%, 10.20% and 42.19%, respectively. The sleep deficiency rate of primary school studnets was 58.69%, and the physical activity deficiency rate was 65.78%; and there was a statistically significant difference in the rate of insufficient sleep time and physical activity time among primary school students of different grades ( χ 2=56.39, 95.95, P <0.01), with sixth grade students showing the highest rates for both sleep and physical activity deficiencies (64.35%, 73.37%). Additionally, 49.78% of students had recess time below the standard requirements. Conclusion The health status of daily learning time among primary school students in Shandong Province is poor, with insufficient implementation of school standards, and the implementation of standards needs to be further strengthened.

Objective: To understand the implementation of daily study time standard among secondary school students in Shandong Province, so as to provide scientific basis for the formulation and implementation of relevant policies. Methods: From January to May 2023, a multi stage random sampling method was used to select 8 725 middle school students in Shandong Province. A survey questionnaire was designed based on the Requirements for Daily Study Time of Primary and Secondary School Students(GB/T 17223-2012), to investigate indicators such as students daily learning schedule, sleep and physical activity time, break time and scheduling requirements. Results: The compliance rates for daily study time in junior and senior high school students in Shandong Province were 29.2% and 23.6%, respectively, with a statistically significant difference ( χ 2=33.63, P <0.01). Compliance rates for sleep duration, physical activity and recess time, morning and afternoon class hours, and class duration were 19.3%, 26.2%, 30.5%, 73.2% and 16.2%. Class duration compliance was relatively high, with rates of 96.7% in junior high and 94.4% in senior high school students. There was a statistically significant difference in compliance rates for extended class breaks between different educational stages ( χ 2= 81.78, P <0.01), with rates of 84.6% in junior high and 83.4% in senior high school students. As students progressed through their educational stages, compliance rates for physical activities, class breaks, consecutive classes, and total weekly class hours showed a decreasing trend, with rates of 31.8% and 18.3%, 35.7% and 23.1%, 60.5% and 29.6%, 55.2% and 35.1% in junior and senior high school students, respectively. Conclusions The revised standard of Requirements for Daily Study Time of Primary and Secondary School Students(GB/T 17223-2012) optimizes the daily study and life schedule of middle school students to a certain extent. However, daily study time for middle school students in Shandong Province exceeds standard. Relevant departments need to enhance their ability to implement standards and strengthen the supervision of policy standards implementation.

This study utilized a chiral liquid chromatography-mass spectrometry (LC-MS)-guided isolation strategy to accurately capture angular-type pyranocoumarins (APs) in Peucedani Radix (Chinese name: Qianhu). Sixteen APs were successfully purified from the ethyl acetate extract of Peucedani Radix through deploying various techniques such as silica gel, ODS, Sephadex LH-20, and achiral (chiral) semi-preparative liquid chromatography. After extensive structural measurements, such as ¹H and ¹³C NMR spectroscopy, their structures were identified as (3′S)-3′-(2-methyl-butyroyl)-4′-oxo-3′,4′-dihydroseselin (1A), (3′R)-3′-(2-methyl-butyroyl)-4′-oxo-3′,4′-dihydroseselin (1B), (3′S)-3′-isovaleryl-4′-oxo-lomatin (2A), (3′R)-3′-isovaleryl-4′-oxo-lomatin (2B), (3′S)-3′-angeloyloxy-4′-oxo-3′,4′-dihydroseselin (3A), (3′R)-3′-angeloyloxy-4′-oxo-3′,4′-dihydroseselin (3B), (3′S,4′S)-praeruptorin B (4A), (3′R,4′R)-praeruptorin B (4B), (3′S,4′S)-praeruptorin E (5A), (3′R,4′R)-praeruptorin E (5B), 3′-isovaleryl-4′-angeloyl-cis-khellactone (6), 3′-angeloyl-4′-(2-methyl-butyroyl)-cis-khellactone (7), (3′S,4′S)-praeruptorin A (8A), (3′R,4′R)-praeruptorin A (8B), (3′S,4′S)-khellactone (9A), and (3′R,4′R)-khellactone (9B), respectively. Thereof, compounds 1A and 1B were new compounds, while compound 2A represents a new configuration for a known planar structure. Compounds 2A and 2B were isolated for the first time from Peucedani Radix. Above all, chiral LC-MS-guided isolation strategy is advantageous at rapid capturing new compounds from herbal medicines, providing an effective means for the separation of novel structures, especially new enantiomers.

Objective A typical case survey and elemental analysis of the implementation of Antimicrobial Steward-ship(AMS)in a medical institution in Shanghai,summarize the excellent experience of AMS in practice,and pro-vide a reference for the further promotion and implementation of AMS in the future.Methods Through purposive sam-pling,7 typical hospitals in Shanghai were selected as sampling hospitals,and key informed persons of AMS were invited to conduct semi-structured interviews.Based on the core elements of AMS theory,it conducted subject analysis to summarize the implementation and excellent practical experience of AMS in hospitals.Results The sample hospitals are excellent in the AMS elements of leadership and accountability,but need to be further strengthened in training,tracking and reporting.On the basis of routine bundle of interventions,some hospitals actively explored and expanded AMS actions according to their own disciplinary advantages.Combined with a series of internal and ex-ternal control measures,AMS strategy with the characteristics of hospitals has been formed,and the related indica-tors of antibiotics in hospitals have been improved.Conclusion In the follow-up process of AMS,hospitals can draw on excellent experience,carry out the appropriate AMS strategy on the basis of consolidating their own governance structure and routine interventions.Besides,relevant departments should increase investment in AMS information systems and human resources in hospitals to ensure the implementation of AMS.

Objective A typical case survey and elemental analysis of the implementation of Antimicrobial Steward-ship(AMS)in a medical institution in Shanghai,summarize the excellent experience of AMS in practice,and pro-vide a reference for the further promotion and implementation of AMS in the future.Methods Through purposive sam-pling,7 typical hospitals in Shanghai were selected as sampling hospitals,and key informed persons of AMS were invited to conduct semi-structured interviews.Based on the core elements of AMS theory,it conducted subject analysis to summarize the implementation and excellent practical experience of AMS in hospitals.Results The sample hospitals are excellent in the AMS elements of leadership and accountability,but need to be further strengthened in training,tracking and reporting.On the basis of routine bundle of interventions,some hospitals actively explored and expanded AMS actions according to their own disciplinary advantages.Combined with a series of internal and ex-ternal control measures,AMS strategy with the characteristics of hospitals has been formed,and the related indica-tors of antibiotics in hospitals have been improved.Conclusion In the follow-up process of AMS,hospitals can draw on excellent experience,carry out the appropriate AMS strategy on the basis of consolidating their own governance structure and routine interventions.Besides,relevant departments should increase investment in AMS information systems and human resources in hospitals to ensure the implementation of AMS.