Objective To introduce practice efficacy and achievement of medical waste management project in medical institutions.Methods Twenty pilot medical institutions in 6 provinces and 1 520 extended medical institutions in each provinces (municipality, city) in China were selected to perform medical waste management project, the current situation of medical waste management in China was explored to develop a new feasibility plan and practice.ResultsCatalogue of medical waste classification (revised manuscript) and Medical waste classification collection list) were formulated, which enhanced supervision ability of medical and health administration on medical waste management.Medical waste management training system was established, best available techniques/best environmental practices(BAT/BEP)for medical waste management were achieved, cooperation and promotion ability of medical waste management project was strengthened.Conclusion Medical waste management project has made great achievements since it is implemented in medical institutions, the achievement can be used as reference for medical waste management in China.

Objective:To explore implementation of post training in Central Sterile Supply Department (CSSD) based on Analysis, Design, Development, Implementation and Evaluation model (ADDIE model) , so as to explore its training effects.Methods:From January to August 2021, the development of post training courses for CSSD were completed according to ADDIE model, and 54 CSSD staff in the Second Hospital of Jilin University were selected by the convenient sampling method for post training. After the training, the Korotkoff evaluation method was used to evaluate the training effect from the aspects of CSSD staff satisfaction, theoretical assessment results and implementation rate of key technologies.Results:The satisfaction of CSSD staff with post training based on the ADDIE model was (88.44±4.01) , which was higher than the (79.72±4.90) of traditional training, and the difference was statistically significant ( P<0.01) . After the post training based on the ADDIE model, the theoretical assessment score of CSSD staff was (90.07±6.09) , and the score before training was (81.30±7.28) , and the difference was statistically significant ( P<0.05) . In addition, the implementation rate of the key technologies of the posts was higher than before the training. Except for the sterilization post, there were statistically significant differences in the cleaning post, packaging post, distribution post and receiving post ( P<0.05) , and the frequency of adverse events was 0. Conclusions:Post training based on the ADDIE model can effectively improve the ability of CSSD staff and promote positive changes in their work behavior. Both CSSD staff and hospitals have a high degree of recognition for this training.

Objective:To explore the occurrence and risk factors of interstitial pneumonia (IP) in patients with diffuse large B-cell lymphoma (DLBCL) after the treatment of CHOP-like regimens containing liposomal doxorubicin.Methods:The clinical data of 145 newly diagnosed and newly treated DLBCL patients who were admitted to the Affiliated Tumor Hospital of Xinjiang Medical University from January 2013 to June 2020 were retrospectively analyzed, of which 73 cases were treated with RCDOP regimen containing liposomal doxorubicin, and 72 cases were treated with RCHOP regimen. The incidence of IP was compared between the two groups, and the risk factors of IP were analyzed by multivariate logistic regression.Results:In 145 patients, 34 patients (23.4%) developed IP; most cases of IP occurred during 3 to 5 cycles of chemotherapy, accounting for 79.4% (27/34); when IP occurred, the median cycles of chemotherapy was 4 cycles. The incidence of IP in RCDOP regimen group and RCHOP regimen group were 31.5% (23/73) and 15.3% (11/72), and the difference was statistically significant ( χ2 = 5.319, P < 0.05). Multivariate logistic regression analysis showed that the application of liposomal doxorubicin ( OR = 2.416, 95% CI 1.059-5.509, P = 0.036) and age ≥60 years old ( OR = 2.505, 95% CI 1.127-5.567, P = 0.024) were independent risk factors for the occurrence of IP. Conclusions:The application of liposomal doxorubicin is a risk factor for the occurrence of IP in DLBCL patients. The prevention and monitoring of IP should be strengthened after 4 cycles of treatment with RCDOP regimen, especially for patient ≥ 60 years of age.

Objective To investigate the effects of atorvastatin calcium on thyroid function,im-mune response and C-Jun N-terminal kinase/p38 mitogen-activated protein kinase(JNK/p38 MAPK)signaling pathway in rats with hypothyroidism.Methods A total of 30 healthy adult male SD rats were randomly divided into control group,hypothyroid group(PTU group)and atorvastatin calcium treatment group(ACT group),with 10 rats in each group.Rats in the PTU group and the ACT group were injected with PTU subcutaneously at the dorsum of the neck every day for 28 consecutive days;instead of PTU,rats in the control group were injected subcutaneously with 0.3 mL of saline.After 2 weeks of PTU treatment,rats in the ACT group were gavaged with 3 mL of atorvastatin calcium sa-line solution(containing 5 mg/kg of atorvastatin calcium),which was administered once daily;the control group was gavaged with an equal amount of saline in the same way.The body weight,food intake and water intake of rats were measured weekly.The histopathological changes of the thyroid gland were observed in histopathological sections of rats in each group.Enzyme-linked immunosor-bent assay(ELISA)was performed to determine the levels of triiodothyronine(T3),thyroxine(T4),thyroid stimulating hormone(TSH),interferon γ(IFN-γ)and interleukin-4(TL-4)in ser-um;quantitative reverse transcriptase polymerase chain reaction(qRT-PCR)was performed to de-tect the mRNA expression levels of IFN-γ,IL-10,Foxp3 and IL-4;western blot was performed to determine the levels of p-JNK/JNK and p-p38/p38 MAPK.Results Compared with control group,PTU-induced hypothyroidism rats showed a significant decrease in body mass and food and water consumption(P＜0.05).After 2 weeks of treatment with atorvastatin calcium,the body mass loss of PTU rats was inhibited,food and water consumption was improved,and the differences were sta-tistically significant(P＜0.05).Atorvastatin calcium was able to significantly increase the serum T3 and T4 levels and decrease the serum TSH level in hypothyroid rats(P＜0.05).Atorvastatin calcium treatment was able to significantly alleviate histopathological changes such as follicular cell proliferation and related hypertrophy induced by PTU,and increase follicular size(P＜0.05).Af-ter treatment with atorvastatin calcium,the spleen mass of PTU rats increased significantly,and the expression of IFN-γ mRNA in hypothyroid rats decreased significantly,but the expression levels of IL-10 mRNA,Foxp3 mRNA and IL-4 mRNA increased significantly(P＜0.05).After treatment with atorvastatin calcium,the levels of p-JNK/JNK and p-p38/p38 MAPK in thyroid tissue of hypo-thyroid rats decreased significantly(P＜0.05).Conclusion Atorvastatin calcium treatment for hy-pothyroidism has the function of promoting the normalization of thyroid hormone imbalance,balan-cing Th1/Th2 cytokines,and inhibiting the activation of JNK/p38 MAPK signaling pathway.

Objective To investigate the effects of atorvastatin calcium on thyroid function,im-mune response and C-Jun N-terminal kinase/p38 mitogen-activated protein kinase(JNK/p38 MAPK)signaling pathway in rats with hypothyroidism.Methods A total of 30 healthy adult male SD rats were randomly divided into control group,hypothyroid group(PTU group)and atorvastatin calcium treatment group(ACT group),with 10 rats in each group.Rats in the PTU group and the ACT group were injected with PTU subcutaneously at the dorsum of the neck every day for 28 consecutive days;instead of PTU,rats in the control group were injected subcutaneously with 0.3 mL of saline.After 2 weeks of PTU treatment,rats in the ACT group were gavaged with 3 mL of atorvastatin calcium sa-line solution(containing 5 mg/kg of atorvastatin calcium),which was administered once daily;the control group was gavaged with an equal amount of saline in the same way.The body weight,food intake and water intake of rats were measured weekly.The histopathological changes of the thyroid gland were observed in histopathological sections of rats in each group.Enzyme-linked immunosor-bent assay(ELISA)was performed to determine the levels of triiodothyronine(T3),thyroxine(T4),thyroid stimulating hormone(TSH),interferon γ(IFN-γ)and interleukin-4(TL-4)in ser-um;quantitative reverse transcriptase polymerase chain reaction(qRT-PCR)was performed to de-tect the mRNA expression levels of IFN-γ,IL-10,Foxp3 and IL-4;western blot was performed to determine the levels of p-JNK/JNK and p-p38/p38 MAPK.Results Compared with control group,PTU-induced hypothyroidism rats showed a significant decrease in body mass and food and water consumption(P＜0.05).After 2 weeks of treatment with atorvastatin calcium,the body mass loss of PTU rats was inhibited,food and water consumption was improved,and the differences were sta-tistically significant(P＜0.05).Atorvastatin calcium was able to significantly increase the serum T3 and T4 levels and decrease the serum TSH level in hypothyroid rats(P＜0.05).Atorvastatin calcium treatment was able to significantly alleviate histopathological changes such as follicular cell proliferation and related hypertrophy induced by PTU,and increase follicular size(P＜0.05).Af-ter treatment with atorvastatin calcium,the spleen mass of PTU rats increased significantly,and the expression of IFN-γ mRNA in hypothyroid rats decreased significantly,but the expression levels of IL-10 mRNA,Foxp3 mRNA and IL-4 mRNA increased significantly(P＜0.05).After treatment with atorvastatin calcium,the levels of p-JNK/JNK and p-p38/p38 MAPK in thyroid tissue of hypo-thyroid rats decreased significantly(P＜0.05).Conclusion Atorvastatin calcium treatment for hy-pothyroidism has the function of promoting the normalization of thyroid hormone imbalance,balan-cing Th1/Th2 cytokines,and inhibiting the activation of JNK/p38 MAPK signaling pathway.

Objective: To investigate the incidence and pathogen distribution of ventilator-associated pneumonia (VAP) among preterm infants admitted to level Ⅲ neonatal intensive care units (NICU) in China. Method: A prospective study was conducted in 25 level Ⅲ NICU, enrolling all preterm infants <34 weeks gestational age admitted to the participating NICU within the first 7 days of life from May 2015 to April 2016. Chi-square test, t test and Mann-Whitney U test were used for statistical analysis. Result: A total of 7 918 patients were enrolled, within whom 4 623(58.4%) were males. The birth weight was (1 639±415) g and the gestational age was (31.4±2.0) weeks; 4 654(58.8%) infants required non-invasive mechanical ventilation and 2 154(27.2%) required intubation. Of all the mechanically ventilated patients, VAP occurred in 95 patients. The overall VAP rate was 7.0 episodes per 1 000 ventilator days, varying from 0 to 34.4 episodes per 1 000 ventilator days in different centers. The incidence of VAP was 9.6 and 6.0 per 1 000 ventilator days in children′s hospitals and maternity-infant hospitals respectively, without significant differences (t=1.002, P=0.327). Gram-negative bacilli (76 strains, 91.6%) were the primary VAP microorganisms, mainly Acinetobacter baumannii (24 strains, 28.9%), Klebsiella pneumonia (23 strains, 27.7%), and Pseudomonas aeruginosa (10 strains, 12.0%). Conclusion The incidence of VAP in China is similar to that in developed counties, with substantial variability in different NICU settings. More efforts are needed to monitor and evaluate the preventable factors associated with VAP and conduct interventions that could effectively reduce the occurrence of VAP.

Objective: To investigate the effect of hypertensive disorder complicating pregnancy (HDCP) on the mortality and early complications of premature infants. Methods: The general clinical data of preterm infants with gestational age 24-36^{+ 6} weeks were collected from the cooperative units in the task group from January 1, 2013 to December 31, 2014.According to the severity of HDCP, the infants were divided into 4 groups: HDCP group, preeclampsia group, eclampsia group and non HDCP group, the mortality and major complications of preterm infants were compared, and the influencing factors were analyzed. Results: The mortality rate of preterm in the HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=9.970, P=0.019). Eclampsia had a highest fatality rate (4.8%) in the early stage, compared with non HDCP group (2.2%), and the difference was statistically significant.Comparison of HDCP group (1.8%) and eclampsia group (3.2%) suggested that there was no statistically significant difference.The incidence of respiratory distress syndrome (RDS) in preterm in HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=13.241, P=0.004). Eclampsia group showed the highest incidence (35.4%), compared with non HDCP group (16.2%), the difference was statistically significant, but compared with HDCP group (19.9%), preeclampsia group (17.1%), there was no significant diffe-rence.The incidence of bronchopulmonary dysplasia (BPD) in preterm in HDCP group was significantly higher than that of non HDCP group (χ²=9.592, P=0.022), the highest incidence showed up in eclampsia group (9.7%), compared with non HDCP group (2.0%) and HDCP group (1.7%), the difference was statistically significant.But there was no statistically significant difference, compared with preeclampsia group.As the degree of HDCP aggravated, the incidence of BPD gradually rose.There was no significant impact on necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) and sepsis of HDCP (χ²=7.054, 7.214, 0.358, 3.852; P=0.070, 0.065, 0.949, 0.278). Considering the overall outcome of the child, that was, whether the child died or survived, he had at least one complication, and HDCP had an effect on it (χ²=15.697, P=0.001), so the incidence increased while the degree of HDCP rose gradually.After adjusting gestational age, birth weight, sex, way of delivery, placental abruption and front placenta, prenatal hormonal, gestational diabetes, neonatal asphyxia and other factors, the results displayed that HDCP was the factor leading to the death of premature baby (OR=2.159, 95%CI: 1.093-4.266), and comparison between preeclampsia and eclampsia showed no statistical difference (P=0.714, 0.389); HDCP had no significant influence on RDS, BDP, ICH, NEC, ROP and sepsis. Conclusions HDCP leads to increased risk of premature death, but also leads to the increased incidence of RDS and BPD, but it had no obvious effect on NEC, ROP, IVH, sepsis and other complications.