Abstract:Public health is a public service that is related to the health of the general public in a country or region. This article traces back to 1911-2023 and summarizes the major public health events during multiple periods, including the beginning of public health during the Yale period, the initial establishment of Xiangya, and the establishment of the Faculty of Health of Hunan Medical College. It is the first systematic compilation of the history of Xiangya public health discipline. The milestones in the history of Xiangya public health discipline are as follows: (1) Dr. Yan Fuqing was the founder of health and public health around the establishment of Xiangya, and is the first person to propose the term 'public health’. (2) The course of Health and Public Health in Xiangya began in 1916 and was offered in the academic year of 1918-1919. (3) Until the establishment of the Faculty of Health in 1975, the course of Health and Public Health was compulsory for Xiangya students. (4) In 1988, the Faculty of Health was renamed as the Faculty of Preventive Medicine, and the Institute of Preventive Medicine was established; In 1995, it was renamed as the School of Public Health of Hunan Medical University. In April 2000, after the merger and establishment of Central South University, it was renamed as the School of Public Health of Central South University; In 2015, it was renamed as Xiangya School of Public Health of Central South University. Xiangya Public Health has been involved in almost all major public health work in China since its beginning, adhering to the principle of prevention first, promoting and serving people’s health.

Abstract:Objective To explore the correlation between lung injury and human neutrophil lipocalin (HNL) in rats with sepsis. Methods 45 rats were randomly divided into a control group, a sham group, and a model group. The model group was to construct a rat sepsis lung injury model, the sham group was to free cecum laparotomy and then close abdomen without ligation and puncture, and the control group was with healthy rats. Serum interleukin (IL)-6 , IL-1 β, tumor necrosis factor-α (TNF-α), and HNL in each group of rats were detected with reagent kit. Oxygenation index was detected by blood gas analysis system. Lung wet/dry (W/D) ratio was calculated. Pathological morphology of lung tissue was observed by HE staining, and lung injury score was calculated. Results There were no significant differences in IL-6, IL-1β, TNF-α, HNL levels, oxygenation index, lung tissue wet/dry ratio, and lung injury score between the control group and the sham group at 12, 24 and 36 hours (all P>0.05). Compared with the sham group, IL-6, IL-1β, TNF-α, HNL levels, oxygenation index, lung tissue wet/dry ratio, and lung injury score in the model group increased at 12, 24 and 36 hours, with significant differences (all P<0.05). At 12, 24 and 36 hours, lung tissue structure of rats was normal in the control group, with no edema observed; there were only a few inflammatory cells in the lung tissue of rats from the sham group; while in the model group, lung tissue structure of rats was severely injured, pulmonary alveoli collapsed, and inflammatory cells were severely infiltrated, but pathology improved with time. In rats with sepsis and lung injury, HNL was positively correlated with IL-6, IL-1β, TNF-α, lung wet/dry ratio, and lung injury scores (all P<0.05), while negatively correlated with oxygenation index (P<0.05). Conclusion In rats with sepsis lung injury, HNL increases significantly, with severe inflammation and aggravation in lung tissue wet/dry ratio and lung injury, while oxygenation index decreases. HNL level is positively correlated with IL-6, IL-1β, TNF-α levels, lung tissue wet/dry ratio and lung injury, but negatively correlates with oxygenation index.

Abstract:Objective To systematically evaluate the application efficacy of failure mode and effect analysis (FMEA) management mode in the prevention and control of healthcare-associated infection (HAI). Methods Li-terature on the application of FMEA management mode in HAI prevention and control were retrieved from PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Database, Wanfang Database, and China Biomedical Literature Database (CBM). Two researchers independently screened the literature, extracted data, and conducted cross checking. Risk and quality assessments were performed on the included studies of randomized controlled trials by ROB tool, the included cohort studies were scored by Newcastle-Ottawa (NOS) scale, and Meta-analysis was conducted by RevMan 5.4 software. Results A total of 22 studies involving 42 815 patients were included in the analysis, with 21 784 in the FMEA management mode group and 21 031 in the control group. Meta-analysis results showed that the incidence of HAI in the FMEA management mode group was lower than that in the control group (OR=0.31, 95%CI ［0.24, 0.40］). Compared with the conventional management mode, incidences of superficial surgical site infection (OR=0.53, 95%CI ［0.36, 0.78］), respiratory system infection (OR=0.44, 95%CI ［0.35, 0.56］), urinary system infection (OR=0.45, 95%CI ［0.38, 0.53］), and blood system infection (OR=0.29, 95%CI ［0.18, 0.45］) in the FMEA management mode group were all lower (all P<0.01). Conclusion The application of FMEA management mode in HAI prevention and control can reduce the incidence of HAI, which should be actively promoted in hospital management.

Abstract:Objective To study the role of red blood cell distribution width (RDW) in the prognosis evaluation of multidrug-resistant organism (MDRO) pulmonary infection (PI) in patients in intensive care unit (ICU). Methods Patients with MDRO PI in the ICU of a hospital from January 2021 to December 2022 were selected, they were divided into good prognosis group and poor prognosis group based on the prognosis. Basic information and serological indicators between two groups of patients were compared, including RDW (RDW coefficient of variation ［RDW-CV］, RDW standard deviation ［RDW-SD］), D-dimer, procalcitonin (PCT), high-sensitivity troponin (TNTsh), N-terminal pro-B-type natriuretic peptide (NT-proBNP), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and interleukin-6 (IL-6). Univariate t-test and multiple logistic regression were adopted to analyze the correlation factors between serological indicators and the prognosis of MDRO PI patients, receiver operating characte-ristic (ROC) curves were used to evaluate the predictive efficacy of RDW on the prognosis of MDRO PI patients. Results A total of 275 cases of MDRO PI were included in analysis, age range from 22 to 99 years old; 181 cases (65.8%) were in good prognosis group, 94 cases (34.2%) in poor prognosis group. The levels of PCT, D-dimer, RDW-CV, RDW-SD, TNTsh, and NT-proBNP in the poor prognosis group were all higher than those in the good prognosis group, differences were all statistically significant (all P<0.05). Multivariate logistic regression analysis showed that the increase of RDW-CV (OR=19.011, 95%CI ［5.247-68.882］, P<0.05) and RDW-SD (OR=13.693, 95%CI ［3.820-49.087］, P<0.05) were associated with poor prognosis in patients with MDRO PI. ROC curve results showed that the areas under the curve of RDW-CV and RDW-SD were 0.901 and 0.896, respectively, with optimal cutoff values of 14.45% and 49.60%, respectively. Conclusion This study suggests that RDW value is closely related to the disease outcome of MDRO PI patients, and is expected to become one of the prognostic evaluation indicators, achieve early intervention and risk assessment.

Abstract:Objective To explore the molecular epidemiological characteristics of carbapenem-resistant Klebsiella pneumoniae (CRKP), and reveal its mechanism of resistance to ceftazidime/avibactam (CZA). Methods CZA-resistant CRKP strains initially isolated from the Affiliated Hospital of Xuzhou Medical University from January 2021 to September 2023 were collected. The carriage of 5 carbapenemase genes (bla_KPC, bla_NDM, bla_OXA, bla_VIM, bla_IMP) were detected with gene amplification method and colloidal gold method. The relative copy number and expression level of Klebsiella pneumoniae (KP) carbapenemase-producing KP (KPC-KP) was detected with real-time quantitative polymerase chain reaction (RT-qPCR), mutation sites of KPC mutation strains were analyzed with whole-genome sequencing, and epidemic characteristics of CRKP and resistance mechanism to CZA were analyzed. Results A total of 73 CZA-resistant CRKP strains were isolated, with 37 (50.68%) being KPC and NDM co-producing strains, 33 (45.21%) NDM-producing alone (23 strains producing NDM-5 and 10 strains producing NDM-1), and 3 KPC-producing alone. KP-2842 strain was identified as ST11-type KPC-33 variant, KP-2127 and KP-2189 strains produced KPC-2. Compared with KP ATCC BAA-1705, the copy number of bla_KPC in these strains up-regulated by 1.04-3.86 fold, and the expression increased by 6.66-12.93 fold, respectively. Colloidal gold and PCR methods demonstrated good consistency and the ability to detect the enzyme co-producing and KPC-33 variant. Conclusion In this hospital, the resistance of CRKP to CZA is primarily mediated by the metalloenzyme NDM, with co-production of NDM and KPC being a characteristic of CRKP. High copy number and expression level of bla_KPC-2 also contribute to CZA resistance. This study identified the KPC-33 variant for the first time in ST11-type CRKP in Jiangsu Province.

Abstract:Objective To analyze risk factors and pathogenic characteristics of intestinal colonization of carbape-nem-resistant Enterobacterales (CRE) in patients from intensive care unit (ICU). Methods A total of 392 ICU patients who underwent intestinal CRE screening in a tertiary hospital in Changzhou from March to December, 2023 were divided into the colonization group (n=42) and the non-colonization group (n=350) according to the screening results. Clinical data of patients, including age, gender, underlying diseases, malignant tumors, radiotherapy, chemotherapy, infection before the last screening, antimicrobial use, and invasive procedures were collected for the analysis on risk factors and pathogenicity. Results Among 42 patients with positive CRE screening results, 44 CRE strains were detected, mainly Klebsiella pneumoniae (65.91%), followed by Escherichia coli (15.91%) and Enterobacter cloacae (13.64%). The average time from admission in ICU to positive screening results of intestinal CRE in the colonization group was 14 days. Long term use of carbapenem antibiotics (OR=1.47, 95%CI: 1.31-1.65), mechanical ventilation (OR=1.14, 95%CI: 1.06-1.22), and Enterobacterales infection (OR=10.10, 95%CI: 3.28-32.09) were independent risk factors for intestinal CRE colonization. Patients who received carbapenem antibiotics for ≥15 days (χ²=167.52, P＜0.001) and those who received mechanical ventilation for ≥15 days (χ²=101.03, P＜0.001) had higher risks for intestinal CRE colonization. Conclusion In clinical practice, it is necessary to improve pathogen detection, treat Enterobacterales infection timely, choose carbapenem antibiotics carefully, shorten treatment course, actively evaluate indications for mechanical ventilation, and wean off ventilator timely.

Abstract:Objective To study the clinical characteristics and bacterial antimicrobial susceptibility testing results of patients with clinically isolated Ralstonia pickettii (R. pickettii), and provide basis for the rational use of antimicrobial agents. Methods Inpatients with R. pickettii infection who were treated at the Tianjin First Central Hospital from January 2014 to December 2023 were analyzed retrospectively. Clinical characteristics and antimicrobial susceptibility testing results were analyzed. Results A total of 80 strains of Ralstonia spp. were isolated over 10-year period, including 42 (52.5%) non-repetitive strains of R. pickettii. Among 42 R. pickettii strains, 64.3% were isolated from male patients. The strains isolated from sputum, catheter, blood, throat swabs, and drainage fluid specimens accounted for 38.1%, 28.6 %, 19.0%, 4.8%, and 2.4%, respectively. The clinical distribution of R. pickettii was highest in the intensive care unit (ICU), with a proportion of 52.4%. The number of infected patients first increased and then decreased with the years, followed by a slight fluctuation. There was no statistically significant difference in the number of infected patients in each department over the years (P>0.05). R. pickettii had higher susceptibility rates to doxycycline, levofloxacin, ciprofloxacin, and minocycline, susceptibility rates were 78.3%-90.9%, but was completely resistant to compound sulfamethoxazole and cefazolin (100%), it also had higher resistance rates to aztreonam, colistin, cefotetan, tobramycin, amikacin, ceftazidime, and gentamicin (80.0%-97.4%). There was no statistically significant difference in the resistance rates to 21 antimicrobial agents among different years (all P>0.05). Conclusion R. pickettii is mainly from ICU, and the majority of the infected population are adult males. Most strains are isolated from sputum and catheter. R. pickettii presents multidrug resistance. Attention should be paid to the changes in the resistance rates of antimicrobial agents, strengthen the dynamic monitoring of bacterial resistance and guide the rational selection of antimicrobial agents in clinic, implement early and effective treatment to improve the prognosis of the patients.

Abstract:Objective To explore the incidence of long COVID symptoms in patients infected with Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods According to the inclusion and exclusion criteria of literatures, relevant studies without language restrictions published up to 2024 were retrieved from both Chinese and English databases. The Chinese databases were China National Knowledge Infrastructure (CNKI), Wanfang Database, and VIP databases, and the foreign databases were PubMed, Embase, and Web of Science. Three-step screening was used to select literatures, and Stata 17.0 software was used for analysis. Results The incidence of at least one sequelae in patients infected with Omicron variant was 29.62%. The most common symptoms included fatigue (19.10%), joint or muscle pain (11.06%), memory loss (9.71%), brain fog (8.80%), cough (8.42%), headache (7.26%), and sore throat (6.68%). Subgroup analysis results showed that with the extension of follow-up (3 months vs 6 months), the incidence of smell or taste changes was significantly reduced (7.22% vs 0.78%). The higher the proportion of women (<50% vs 50%-65% vs ＞65%), the higher the incidence of joint or muscle pain (1.09% vs 4.62% vs 19.53%); the greater the median age (≥45 years vs ＜45 years), the higher the incidence of chest pain or chest distress (0.90% vs 3.86%), all with statistically significant differences (all P<0.05). Conclusion Incidence of long COVID in Omicron -infected patients is high and can cause various symptoms. Follow-up time, median age and gender proportion have significant impacts on the incidence of some symptoms.

Abstract:Objective To explore characteristics of co-infection of Chlamydia pneumoniae (Cpn) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and identify their effect on SARS-CoV-2-induced inflammatory response. Methods Patients with coronavirus disease 2019 (COVID -19) who received treatment in a hospital in Chenzhou City from December 20, 2022 to February 20, 2023 were selected. According to the severity of COVID -19, severe and critical cases were classified as the severe symptom group, while mild and moderate cases were classified as the mild symptom group. Meanwhile, according to the age of patients (≥18 years old as adults, <18 years old as juveniles), they were divided into the adult severe symptom group, adult mild symptom group, juvenile severe symptom group, and juvenile mild symptom group. Propensity score was adopted to match age, gender, and underlying diseases of patients in severe symptom and mild symptom group in a 1 ∶1 ratio. Bronchoalveolar lavage fluid (BALF), throat swabs, and serum specimens of patients were collected. Cpn IgG/IgM antibody was detected by enzyme-linked immunosorbent assay (ELISA), levels of 12 common cytokines (including interleukin-8 ［IL-8］) in BALF were detected by flow cytometry, differences among groups were compared. Results A total of 102 patients were included, with 61 severe and critical (severe symptom) patients, as well as 41 mild and moderate (mild symptom) patients. There were 71 patients aged ≥18 years and 31 juvenile patients aged <18 years. There were 39 patients in the adult severe symptom group and 32 in the adult mild symptom group, and 30 pairs were successfully matched through propensity score analysis. There were 22 patients in the juvenile severe symptom group and 9 in the juvenile mild symptom group, and 8 pairs were successfully matched through propensity score analysis. Among COVID -19 patients, the positive rates of Cpn IgG and IgM were 36.27% (n=37) and 8.82% (n=9), respectively, with 1 case positive for both Cpn IgG and IgM. The level of interferon (IFN) - α in serum specimens from adult patients with severe symptom combined with positive Cpn IgG was higher than that of IgG negative patients (P=0.037). There was no statistically significant difference in the levels of other cytokines in BALF and serum specimens between the two groups of patients (all P>0.05). The levels of IL-8 and IL-17 in serum specimens of patients with positive Cpn IgG in the adult mild symptom group were both higher than those in Cpn IgG negative patients (both P<0.05). The levels of IL-8 in both BALF and serum specimens from Cpn IgM positivity patients in the juvenile mild symptom group were higher than those from patients with negative Cpn IgM (both P<0.05). Logistic regression analysis results showed that Cpn IgG and IgM positivity were not risk factors for the development of severe COVID -19. Conclusion Combined Cpn infection is not a risk factor for the development of severe symptom in COVID -19 patients, and Cpn infection has limited impact on the secretion of inflammatory factors caused by SARS-CoV-2.

Abstract:Objective To analyze the application effect of active intervention mode in improving the quality of detection of pathogens from department of obstetrics. Methods Inpatients receiving therapeutic antimicrobial therapy in the department of obstetrics in a hospital from January 2022 to December 2023 were selected as the research subjects, active intervention measures were implemented based on the pathogen detection rate and specimen qualified rate. January-December 2022 was pre-intervention stage and January-December 2023 was post-intervention stage. Relevant indicators before and after the active intervention were compared and analyzed to evaluate the intervention efficacy. Results Therapeutic antimicrobial use rate in obstetric inpatients after active intervention was lower than before intervention (5.08% vs 11.87%). The proportion of targeted pathogen specimen detection before antimicrobial therapy after active intervention was higher than before active intervention (54.63% vs 8.04%), among which the proportions of blood culture (24.67% vs 5.15%), urine culture (4.41% vs 1.65%), fetal membrane culture (11.01% vs 0.41%), cervical secretion culture (5.29% vs 0.41%), and amniotic fluid culture (9.25% vs 0.41%) after intervention all increased compared with before intervention, and the differences were all statistically significant (all P<0.05). The qualified rate of microbial culture specimens from department of obstetrics after active intervention was higher than before active intervention (91.13% vs 66.67%), with statistically significant difference (P<0.001). Conclusion Active intervention mode not only improve the health care workers’ awareness on targeted pathogen detection, but also increase the qualified rate of microbial culture detection, effectively improve the quality of detection of pathogens from department of obstetrics.

Abstract:Objective To explore the independent risk factors for central line-associated bloodstream infection (CLABSI), provide basis for developing intervention measures for infection prevention and control as well as conducting targeted treatment. Methods Patients who were diagnosed with CLABSI in a hospital from January 2019 to December 2023 were recruited retrospectively and defined as the infection group. According to 1 ∶4 propensity score matching method, patients who received central venous catheter (CVC) without infection were taken as the control group. With whether CLABSI occurred as the dependent variable, the possible risk factors of the matched two groups as the independent variables, logistic regression analysis was conducted, and independent risk factors for patients developing CLABSI were explored. Results A total of 42 patients in the CLABSI group and 168 patients in the non-CLABSI group were matched. Multivariate logistic regression analysis showed that high score of acute physiology and chronic health evaluation (APACHE) Ⅱ (OR=1.217, 95%CI ［1.094-1.357］, P<0.001), long duration of central venous catheterization (OR=1.273, 95%CI ［1.157-1.400］, P<0.001), and femoral venous catheterization (OR=6.846, 95%CI ［1.511-31.014］, P=0.013) were independent risk factors for CLABSI. A total of 118 strains of pathogens were isolated from 42 CLABSI patients, with Gram-negative bacteria being the majority (n=56). Conclusion High score of APACHE Ⅱ, long duration of central venous catheterization, and femoral venous catheterization are independent risk factors for CLABSI. The main pathogens are Gram-negative bacilli. Strict prevention and control measures for CLABSI should be implemented to reduce the risk of infection.

Abstract:Objective To understand the prevalence characteristics of influenza and changes of influenza virus strains, and provide reference for the prevention and control of influenza in the province. Methods Surveillance data about influenza in Hunan Province from 2014 to 2023 were exported from China Influenza Surveillance Information System. Differences in the percentage of influenza-like illness (ILI) cases (percentage of influenza-like cases ［ILI%］ in outpatient and emergency department visits) among different years and different populations, as well as the positive rate of influenza virus in ILI specimens were compared. Results From 2014 to 2023, over 2.65 million cases of ILI were reported, with an ILI% of 4.70%. ILI% among different years presented statistically significant differences (P<0.001). People aged 0-14 years old were the main population with ILI, accounting for 82.90%. The positive rate of influenza virus in ILI specimens was 14.14%, the positive rate of influenza virus among diffe-rent years and age groups were both significantly different (both P<0.001). The main prevalent influenza strains from 2014 to 2023 included types A (H1N1), A (H3N2), B (Victoria), and B (Yamagata), alternating among di-fferent years. However, type B (Yamagata) strains were not detected from 2020 to 2023. There were basically two influenza prevalence seasons every year, namely winter-spring and summer. Conclusion People <15 years old are the main population of influenza, and the prevalence peaks are in winter-spring and summer. From 2021 to 2023, the prevalence alternates mainly among 3 types: A (H1N1), A (H3N2), and B (Victoria).

Abstract:Objective To explore the potential influencing factors of post-operative healthcare-associated infection (HAI) in colorectal cancer patients, as well as the mediating effect relationship between the influencing factors and the diagnosis-intervention packet (DIP) payment differentials. Methods Medical data of patients who underwent colorectal cancer surgery in a tertiary first-class cancer hospital in Guangzhou were retrospectively analyzed. According to HAI status, patients were divided into infection group and non-infection group. Baseline demographic information and differences in DIP payment differentials between two groups of patients were compared by rank sum test or chi-square test. The influence of each potential factor on the occurrence of HAI was analyzed by logistic regression. Mediating analysis was preformed by bootstrap method, and mediating effect of HAI and total hospitalization days on DIP payment differentials was evaluated. Results A total of 350 patients were included in analysis, 50 were in the infection group and 300 in the non-infection group. The incidence of HAI was 14.29%. Logistic regression analysis result showed that risk of HAI in patients with central venous catheterization ≥10.00 days was 13.558 times higher than that <10.00 days (P<0.001); risk of HAI in patients with urinary catheterization ≥3.00 days was 2.388 times higher than that <3.00 days (P=0.022). There were all statistically significant differences in DIP payment differentials among patients with different ages, prognostic nutritional index (PNI), HAI status, total length of hospitalization stay, duration of surgery, central venous catheterization days, and catheterization days (all P<0.05). The mediating analysis results showed that the occurrence of HAI resulted a change in DIP payment di-fferentials by affecting the total number of hospitalization days. The mediating effect value of total hospitalization days was 0.038, accounting for 35.68% of the total effect. Conclusion Medical institutions should pay attention to HAI resulting from prolonged central venous and urinary catheterization in patients underwent surgery for colorectal cancer, reducing the total length of hospital stay, thus reducing the overruns associated with the increased DIP payment differentials.

Abstract:Objective To track and evaluate the improvement efficacy of a 3-year continuous implementation of special action of "Improving the pathogen detection rate before antimicrobial therapy", and provide evidence-based basis for future work. Methods Clinical data of inpatients in a tertiary comprehensive hospital from 2020 to 2023 were collected. The baseline survey result in 2020 was taken as the pre-improvement group, and the continuous implementation of special action improvement goal from 2021 to 2023 was as the post-improvement group. Measures were taken, including improving the information system, establishing a multi-department collaboration mechanism, providing multi-level training and education for all staff, standardizing medical behavior and pathogen detection processes, and strengthening supervision efficiency. Indicators were dynamically tracked and strategies were fo-llowed up promptly. Monitoring and data acquisition were carried out through the hospital infection information system. R 4.1.3 statistical software was adopted to compare the differences between two sets of indicators and the changing trends of data in different years, and the improvement efficacy was evaluated. Results After promoting the improvement goal of 3-year special action, the therapeutic antimicrobials usage rate decreased, presenting a downward trend with years (P<0.001). Pathogen detection rate before antimicrobial therapy increased from 39.38% to 85.40%; blood culture detection rate increased from 14.11% to 49.28%; pathogen detection rates before restricted and special antimicrobial therapy increased from 31.76% and 55.97% to 92.11% and 99.10%, respectively; pathogen detection rate before combined use of key antimicrobial agents increased from 83.09% to 97.74%, all presenting increasing trends year by year (all P<0.001). The detection rate of multidrug-resistant organisms decreased. Detection rates of carbapenem-resistant Enterobacterales (CRE) and methicillin-resistant Staphylococcus aureus (MRSA) presented downward trends (P<0.001). Healthcare-associated infection (HAI) diagnosis-related pathogen detection rate remained above 90%. Consistency rate between specimen collection and infection sites increased from 73.26% to 91.67%, with an increasing trend year by year (P<0.05). The internal medicine department had the lowest consistency rate, while the critical care medicine department had the highest consistency rate. Conclusion Three-year continuous promotion of the special action improvement goal and dynamic evaluation have greatly improved the clinical medical personnel’s capability in judging the indicators and detection timing of pathogen specimens accurately, standardized diagnosis and treatment behavior, and guided the correct and rational use of antimicrobial agents in clinical practice, thus reduced the occurrence of bacterial resistance in hospital.

Abstract:Objective To evaluate healthcare-associated infection (HAI) status and influencing factors in coronary heart disease (CHD) patients after percutaneous coronary intervention (PCI) treatment, and construct a risk prediction model. Methods CHD patients who underwent PCI in a hospital from May 2019 to October 2023 were retrospectively selected as the research subjects. Infection status of the CHD patients was analyzed. Patients were randomly divided into a modeling set and a testing set in a 7 ∶3 ratio. Univariate and multivariate logistic regression analyses were performed to analyze the data in the modeling set and determine the influencing factors for HAI in patients. R software was used to construct and validate a nomogram model. Results A total of 858 CHD patients were included in the analysis, 601 in the modeling set and 257 in the testing set. In the modeling set, 41 cases were in the infected group and 560 cases in the non-infected group. The incidence of HAI in CHD patients after PCI treatment was 6.88% (59/858). Infection site were mainly upper respiratory tract and urinary tract. A total of 74 pathogens were isolated, including Gram-positive bacteria, Gram-negative bacteria, and fungi being 39, 31, and 4 strains, respectively. Multivariate analysis showed that old age, combined diabetes, high grade of New York Heart Association (NYHA) classification, and invasive procedures were all risk factors for HAI in CHD patients after PCI treatment (all P<0.05), while high mini-nutritional assessment short-form (MNA-SF) score was a protective factor (P<0.05). The area under the receiver operating characteristic (ROC) curve (AUC) of the nomogram prediction model constructed based on the above five indicators was 0.894 (95%CI: 0.815-0.931), with a sensitivity of 89.0% and a specificity of 82.5%. The testing set data validation showed an AUC value of 0.879 (95%CI: 0.801-0.923), with a sensitivity of 87.5% and a specificity of 81.3%, which were comparable to the modeling set and presented the stability of the model. The H-L goodness of fit test showed no statistical significance (P>0.05), indicating that the model didn’t exhibit overfitting. Calibration curve analysis showed that the model had good consistency. Decision curve analysis confirmed that the model had practical value in clinical practice. Conclusion The nomogram model has a good predictive ability for HAI in CHD patients after PCI treatment, and can provide a simple and effective evaluation tool for medical staff to identify HAI high-risk individuals.

Abstract:The patient, a 42-year-old male, with a history of hepatitis B and membranous nephropathy, had intermittent fever and chills 12 days before admission. In the first 2 days after admission, the patient’s condition aggravated with redness, swelling and pain in the left scrotum and perineum. Immediate surgical debridement was performed. The patient had a persistent low fever, with blood and pus cultures showing Candida albicans positive, thus was diagnosed fungal necrotizing fasciitis and pyomyositis. The patient was treated with echinocandins mica-fungin (150 mg, qd) for antifungal infection, and was given encroaching dressing change, hyperbaric oxygen therapy, nutritional support, etc. Two months after surgery, the patient’s condition improved and he was discharged. The early clinical symptoms of necrotizing fasciitis and pyomyositis caused by Streptococcus spp. infection lack specificity, thus are prone to be delayed. For patients with concomitant immune diseases, attention should be paid to the prevention and early treatment of complex infection. The appropriate selection of empirical antifungal agents at the early stage has clinical significance.

Abstract:The global morbidity and mortality of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are gradually decreasing, but the elderly people are still at higher risk of death than the general population, especially for those with Alzheimer’s disease (AD) . AD is a slowly progressing degenerative disease of the nervous system, and is the most common type of dementia. Its neuropathological features include overproduction and clea-rance imbalance of amyloid β-protein and overphosphorylated tau protein leading to neurofibrillary tangle. People with AD are more susceptible to be infected with SARS-CoV-2, likewise, the virus can also cause AD in those who are infected. After SARS-CoV-2 infection, it affects AD through immune response, inflammatory response, cell aging, DNA damage reaction, autophagy disorder, choroidal homeostasis disorder, over-activation of renin-angiotensin system, and oxidative stress. This article mainly reviews the research progress in the effect of SARS-CoV-2 infection on AD.

Abstract:Candida auris (C. auris) is a fungus with multidrug resistance. Current genomic studies indicate that C. auris shares similarities in genome size and evolution with other resistant yeast species. There are differences in genome size and structural variations among different geographical clades of C. auris, which may be related to differences in phenotype and drug resistance. C. auris exhibits resistance to multiple antifungal agents, including triazole, amphotericin B, and echinocandins. Genomic studies have found that resistance of C. auris may be related to factors such as membrane transport protein and mutation in the ergosterol pathway, its resistance can change further during evolution. In this paper, the relevant studies are reviewed, with a view to understanding the mechanism of drug resistance of C. auris, and providing important basis for formulating prevention and control strategies as well as treatment programs of C. auris.