Sustained Improvement of Appropriateness in Surgical Antimicrobial Prophylaxis with the Application of Quality Control Circle.

Purpose: Quality control circle (QCC) has acquired success in many fields in healthcare industry as a process management tool, whereas its efficacy in surgical antimicrobial prophylaxis (SAP) remains unknown. This study aimed to implement QCC interventions to improve the appropriateness of SAP. Methods: A QCC activity team was established to grasp the current situation of SAP in clean surgery procedure, set target, formulate corresponding countermeasures and implement and review them in stages. The plan-do-check-act (PDCA) method was cyclically applied. Results: The appropriateness of antibiotic prophylaxis before (January to December 2020) and after (January to December 2021) the implementation of QCC activities were evaluated based on relevant international and Chinese SAP guidelines. The overall SAP appropriateness was significantly improved from 68.72% before QCC to 93.7% post QCC implementation (P<0.01). A significant improvement (P<0.05) was also determined for each category: selection (from 78.82% to 96.06%), duration (from 90.15% to 96.46%), indication (from 94.09% to 97.64%), timing of first dose (from 96.55% to 99.21%), antimicrobial usage (from 96.8% to 99.41%), re-dosing of antimicrobial (from 96.55% to 99.21%). Conclusion: Implementation of a QCC program can optimize the use of antibiotics and improve the appropriateness of SAP and is of practical importance to their standardization.

Mere15, a novel polypeptide from Meretrix meretrix, inhibits proliferation and metastasis of human non-small cell lung cancer cells through regulating the PI3K/Akt/mTOR signaling pathway.

Mere15, an anticancer polypeptide with a molecular weight of 15 kDa, is extracted from the marine species Meretrix meretrix. A previous study in our laboratory has confirmed that Mere15 displays a potent antitumor activity. However, the underlying mechanism of Mere15 still remains unclear. The effect of Mere15 on the growth of a variety of tumor cells was measured by the CCK-8 assay. Hoechst33342/PI double staining and flow cytometry assays were used to detect the apoptosis status of cancer cells. Western blotting was used to detect the expression of apoptosis-related proteins, migration and invasion-related protein, and the changes in the PI3K/Akt/mTOR signaling pathway-related proteins. Treatment with Mere15 inhibited cancer cell growth significantly. Scratch wound-healing assay, as well as Transwell experiments, revealed that the polypeptide was able to inhibit the invasion and migration of NSCLC cells significantly. Western blotting analysis confirmed that treatment with Mere15 inhibited the phosphorylation of PI3K, Akt, and mTOR significantly. The effects of Mere15 were also evaluated in the presence of an activator or inhibitor of the PI3K/Akt/mTOR pathway. Downregulated expression of MMP-2, MMP-9, and Snail, and increased expression of E-cadherin were also found in cells treated with Mere15. In vivo study revealed that Mere15 inhibited tumor growth significantly in xenograft nude mice bearing NCI-H460 cancer cells. The study provides evidence that Mere15 has the potential to be developed as a novel antimetastatic agent for the treatment of NSCLC patients. The work also provides further evidence that targeting PI3K/Akt/mTOR pathway is an important strategy for overcoming cancer metastasis.

Targeting Protein Kinase Inhibitors with Traditional Chinese Medicine.

Protein kinases play critical roles in the control of cell growth, proliferation, migration, and angiogenesis, through their catalytic activity. Over the past years, numerous protein kinase inhibitors have been identified and are being successfully used clinically. Traditional Chinese medicine (TCM) represents a large class of bioactive substances, and some of them display anticancer activity via inhibiting protein kinases signal pathway. Some of the TCM have been used to treat tumors clinically in China for many years. The p38mitogen-activated protein kinase (MAPK), phosphoinositide 3-kinase, serine/threonine-specific protein kinases (PI3K/AKT/mTOR), and extracellular signal-regulated kinases (ERK) pathways are considered important signals in cancer cell development. In the present article, the recent progress of TCM that exhibited significant inhibitory activity towards a range of protein kinases is discussed. The clinical efficacy of TCM with inhibitory effects on protein kinases in treating a tumor is also presented. The article also discussed the prospects and problems in the development of anticancer agents with TCM.