The emerging and re-emerging arthropod-borne infectious diseases pose a serious threat to global public health security. Field and laboratory studies of arthropods of medical importance are essential and critical for the prevention and control of arthropod-borne infectious diseases. Various institutions or universities in China have been conducting research in the field or laboratory study of arthropods of medical importance, but up to 2023, it is still lacking detailed biosafety guidelines or recommendations that can guide the related work for arthropods of medical importance. In order to proactively address potential biosafety issues in the field or laboratory activities related to arthropods of medical importance, improve the standardization of arthropod biosafety classification, operations, and protection, and ensure the safety of practitioners, an expert consensus on the biosafety recommendation of arthropods of medical importance in field and laboratory has been developed, aiming to guide the future work of arthropods and ensure the national biosafety and biosecurity of China.

In recent years， enhanced recovery after surgery （ERAS） has been widely used in clinical practice， aiming to optimize perioperative management measures through evidence-based medicine and reduce the physical and mental trauma， stress reactions， and complications of surgical patients through multidisciplinary collaboration. This paper examined the clinical practice of ERAS from the perspective of medical humanities， reviewed its development and characteristics， and first pointed out that the concept of “minimal harm” laid the medical humanities foundation for ERAS. However， the concept of “minimum harm” faced ethical and realistic challenges in practice， such as differentiated cognition between benefits and non-harm， the tension between generalization and personalization， and the gap between rehabilitation continuity and family care. This paper led into the caregiving perspective of social sciences， proposed “optimal care” as a supplement to the medical humanities concept of ERAS， and introduced its connotation and practice. The combination of “minimal harm” and “optimal care” can provide theoretical guidance for medical humanistic care in ERAS and innovate the practical path of medical humanities into clinical practice.

Purpose To explore the ultrasound features and early diagnostic clues of fetal myocardial non-compaction.Materials and Methods The clinical data and echocardiographic data of four fetuses who underwent fetal echocardiography in Henan Provincial People's Hospital from January 2015 to February 2023 and were confirmed to have myocardial non-compaction by pathological finding or postnatal examination were collected,and analyzed.Results A total of four fetuses diagnosed as myocardial non-compaction by prenatal ultrasound:two involved the left ventricle with isolated lesions,and apical myocardial non-compaction was confirmed by postnatal echocardiography;two involved the biventricles,and both of which were pathologically confirmed after induction of labor.The prenatal ultrasound of fetal myocardial involvement in four cases showed that:(1)the affected myocardium showed a bilayer structure:the outer layer was compacted myocardium,which showed thin and compacted homogeneous hypoechoic;the inner layer was loose and thickened non-compacted myocardium with enhanced echogenicity;(2)color Doppler flow imaging:the non-compacted myocardium showed sieve mesh blood flow with ventricular communication.Some cases were associated with cardiac enlargement and arrhythmia.Conclusion Prenatal echocardiography can diagnose fetal myocardial non-compaction with a characteristic echographic presentation.Localized myocardial thickening and echogenic enhancement,cardiac enlargement and arrhythmia may be important clues to identify fetal myocardial non-compaction.

Objective:To investigate the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with maintenance hemodialysis (MHD) in Jiangsu province during SARS-CoV-2 pandemic in China from December 7, 2022 to January 27, 2023, and to analyze the influencing factors of all-cause death.Methods:It was a multi-center cross-sectional investigation. Structured questionnaire was used to collect patient information by medical staff of each hemodialysis center (room) as investigators. Part of the demography data and laboratory examination data came from the Jiangsu Province Hemodialysis Data Information System. MHD patients from hemodialysis centers (rooms) at all levels of medical institutions and independent hemodialysis institutions in Jiangsu province during the outbreak of SARS-CoV-2 infection were included, and the clinical characteristics and all-cause mortality of confirmed and suspected cases of SARS-CoV-2 infection were analyzed.Results:Questionnaire surveys and data analysis on 57 278 patients in 407 hemodialysis centers (rooms) were completed, accounting for 90.41% of the total number of MHD patients (63 357 cases) in Jiangsu province during the same period. There were 24 038 cases (41.97%) of SARS-CoV-2 infection and 14 805 cases (25.85%) of suspected infection, which were widely distributed in all dialysis centers in Jiangsu province. After clinical classification of 38 843 confirmed and suspected SARS-CoV-2 infection cases, 3 662 cases were severe and critical cases, accounting for 9.43% of the infected and suspected cases. Among the patients who had completed the questionnaires, there were 1 812 all-cause deaths, with an all-cause mortality rate of 3.16%. Multivariate logistic regression analysis showed that elderly (taking ≤50 years as a reference, 51-59 years: OR=1.583, 95% CI 1.279-1.933, P=0.001; 60-69 years: OR=3.972, 95% CI 3.271-4.858, P<0.001; 70-79 years: OR=7.236, 95% CI 5.917-8.698, P<0.001; ≥80 years: OR=11.738, 95% CI 9.459-14.663, P<0.001), male ( OR=1.371, 95% CI 1.229-1.529, P<0.001), and co-infection with hepatitis B virus (HBV) (positive serum HBV surface antigen, OR=0.629, 95% CI 0.484-0.817, P<0.001) were independent influencing factors for all cause mortality. Receiver-operating characteristic curve analysis showed that the area under the curve for male, age and current HBV infection prediction of all-cause death was 0.529 ( P<0.001), 0.724 ( P<0.001) and 0.514 ( P=0.042), respectively, and the cut-off value for age prediction of all-cause death was 65.5 years old. Compared with patients without HBV infection, MHD patients with HBV infection significantly reduced the proportion of severe and critically ill patients, all-cause hospitalizations and all cause deaths when infected with SARS-CoV-2 (4.99% vs. 6.41%, χ2=6.136, P=0.013; 8.90% vs. 11.44%, χ2=11.662, P<0.001; 2.01% vs. 3.37%, χ2=10.713, P=0.001, respectively). Conclusion:The MHD patients in Jiangsu province are susceptible to SARS-CoV-2. Elderly age and male gender are independent risk factors for death in MHD patients during the epidemic, while the HBV infection may be a protective factor for death of MHD patients infected with SARS-CoV-2.

Objective:To analyze the clinical characteristics of patients with acute glyphosate herbicide poisoning and the differences in the severity of poisoning.Methods:A retrospective analysis was performed on patients with acute glyphosate herbicide poisoning admitted to the First Affiliated Hospital of Zhengzhou University from January 2014 to December 2020. The general information, exposure time, poisoning dose, poisoning cause, poisoning route, clinical manifestations, laboratory examination results during hospitalization, treatment measures, hospital stays and prognosis of the patients were collected. The patients were graded according to the poisoning severity scoring standard of Chinese Expert Consensus on Diagnosis and Treatment of Acute Poisoning in 2016. The highest severity score during hospitalization was used as the final grade. According to the final grade, asymptomatic and mild patients were included in the mild group, and moderate, severe and death patients were included in the severe group. The independent sample T test or Mann-Whitney U test was used for measurement data, and χ2 test or Fisher's exact test was used for counting data. The differences of general data and clinical data between the two groups were compared. Results:According to the inclusion and exclusion criteria, 83 patients with acute glyphosate herbicide poisoning were selected as the study subjects. All patients survived, mainly mild poisoning (56.6%), with a male to female ratio of 33∶50, and an average age of 39 years. The number of poisoning cases increased yearly (the highest in 2019), and most cases occurred in spring and summer. The main cause of poisoning was suicide (71.1%), direct oral administration (83.1%) was the primary route of poisoning, and the dominating clinical manifestations were digestive symptoms (71.1%). Laboratory tests showed increased white blood cell count (WBC), neutrophil percentage (NEUT %) and D-dimer, and decreased hemoglobin and potassium. Compared with the mild group, patients in the severe group were older [(51±17) years vs. (35±19) years], had a higher proportion of suicide and direct oral administration, a longer hospital stay [8.0 (4.8, 12.0) d vs. 3.0 (2.0, 5.5) d], a higher dose of poisoning [200.0 (50.0, 200.0) mL vs. 30.0 (11.3, 57.5) mL], and higher NEUT % within 24 h of admission [(83.4±10.4) vs. (73.2±12.8)]. The increase of WBC, NEUT %, aspartate aminotransferase, prothrombin time, D-dimer and the decrease of serum potassium were more common in the severe group than the mild group, with statistical significance (all P<0.05). Conclusions:The number of patients with acute glyphosate herbicide poisoning is increasing yearly. Generally, the condition is mild and the prognosis is satisfying. The severity is more serious in the middle-aged and elderly patients andthose with direct oral administration, high toxic dose, and high NEUT % within 24 h of admission. Severe poisoning is more likely to cause changes in laboratory indicators.

In Taiwan, high-risk patients have been identified and tested for preventing community spread of COVID-19. Most sample collection was performed in emergency departments (EDs). Traditional sample collection requires substantial personal protective equipment (PPE), healthcare professionals, sanitation workers, and isolation space. To solve this problem, we established a multifunctional sample collection station (MSCS) for COVID-19 testing in front of our ED. The station is composed of a thick and clear acrylic board (2 cm), which completely separates the patient and medical personnel. Three pairs of gloves (length, 45 cm) are attached and fixed on the outside wall of the MSCS. The gloves are used to conduct sampling of throat/nasal swabs, sputum, and blood from patients. The gap between the board and the building is only 0.2 cm (sealed with silicone sealant). ED personnel communicate with patients using a small two-way broadcast system. Medical waste is put in specific trashcans installed in the table outside the MSCS. With full physical protection, the personnel conducting the sampling procedure need to wear only their N95 mask and gloves. After we activated the station, our PPE, sampling time, and sanitization resources were considerably conserved during the 4-week observation period. The MSCS obviously saved time and PPE. It elevated the efficiency and capacity of the ED for handling potential community infections of COVID-19.
Betacoronavirus ; Clinical Laboratory Techniques ; Coronavirus Infections ; diagnosis ; epidemiology ; Emergency Service, Hospital ; organization & administration ; Humans ; Mass Screening ; methods ; Pandemics ; Personal Protective Equipment ; supply & distribution ; Pneumonia, Viral ; diagnosis ; epidemiology ; Taiwan ; epidemiology

Objective:To explore the application of contrast-enhanced ultrasound (CEUS) combined with mathematical model in differential diagnosis of intrahepatic cholangiocarcinoma (ICC) and prophase of bacterial hepatic abscess (PBHA).Methods:Fifty-one ICC patients (ICC group)and 46 PBHA patients(PBHA group) from January 2010 to April 2019 in Henan Provincial People′s Hospital were analyzed retrospectively. All ICC patients and 41 PBHA patients were confirmed by surgery or puncture pathology, and 5 PBHA patients were confirmed by clinical follow-up. The characteristic information of ultrasound images of the lesions were analyzed.Partial least squares-discriminant analysis (PLS-DA) was used to establish ICC and PBHA mathematical models, and Monte Carlo simulation was used to verify their accuracy. Based on PLS-DA modeling method, variable importance in the projection (VIP) was used to obtain the variables that had a strong influence on identifying the two from all variables.Results:There were significant differences between ICC group and PBHA group in lesion sites, complications, internal characteristics and clearance characteristics of contrast-enhanced arterial phase (all P<0.05). The average positive and negative predictive values of PLS-DA were 92.30% and 91.17%, and the average positive and negative predictive values in the prediction set were 100% and 94.11%, respectively.Variables with VIP value >1 included X2 (complication), X4, X5, X7, X8, X9 (CEUS enhanced features), X10, X11 (clearing features), and these variables could be used as important indicators for differential diagnosis between ICC and PBHA. Conclusions:PLS-DA method based on CEUS parameters can construct a differential diagnosis model for ICC and PHBA, which is expected to provide a valuable and robust diagnostic method for these two diseases which are easily confused and lack of specific imaging manifestations.

Traditional knowledge digital Library (TKDL) is a mature database for protection of traditional knowledge from illicit aggression, and also used for searching and examining the novelty and inventive step of applied inventions. TKDL has the role of defensive protection on Indian traditional medicine through promoting legislation initiatively, signing TKDL access agreement with international intellectual property authorities, and establishing close cooperation with WIPO. TKDL is a typical and successful case. Based on the publication and promotion ways of traditional knowledge digital library and the actual national condition in China, this paper proposes several applicable ways for publication and promotion of traditional knowledge protection directory of traditional Chinese medicine database.

The quarantine inspection and acceptance of laboratory animals is an important work, which can protect animals from pollution, occurrence and spread of diseases in the surounding area, and it is the key point to realize the quality standardization of laboratory animals.Beagle dogs are acknowledged widely as specialized laboratory dogs which is widely employed in experiments of drug safety evaluation because of the good genetic stability, environmental adaptability, disease resistance and consistency testing in the experiments.Establishment of standard operating procedures of beagle dog quarantine acceptance check for drug GLP organization tests, refining technical points, strengthen the technical training of quarantine officers, and efforts to improve the level of quarantine are needed to finally ensure the quality of laboratory animals.

BACKGROUNDProphylactic para-aortic nodal dissection (PAND) has no proven benefits for potentially curable advanced gastric cancer. However, the value of therapeutic PAND for involved para-aortic nodes (PANs) in patients with locally advanced gastric cancers has not been determined yet.

METHODSBetween 1998 and 2010, 157 gastric cancer patients with 1-3 involved PANs underwent extended D2 (D2+) lymphadenectomy plus PAND (PAND group, n = 69) or extended D2 lymphadenectomy alone (non-PAND group, n = 88). The clinicopathologic features and prognostic data were compared between the two groups. A propensity score-adjusted analysis was used for a balanced comparison.

RESULTSThe rate of PAN metastasis was 40.6% (28/69) in the PAND group. The 5-year survival rate was significantly higher in the PAND group than in the non-PAND group (43.7% vs. 31.8%, P = 0.044). Compared to the non-PAND group, the death hazard ratios in the PAND group were 0.45 (95% CI 0.274-0.739; P = 0.002) and 0.536 (95% CI 0.328-0.861; P = 0.0097) by multivariate analysis without and with propensity score adjustment respectively. Recurrence rate at 5 years was 39.1% in the PAND group and 43.2% in the non-PAND group (P = 0.628).

CONCLUSIONExtended D2 lymphadenectomy plus PAND is associated with superior outcomes for advanced gastric cancer patients with 1-3 involved PANs.

Adult ; Aged ; Female ; Humans ; Lymph Node Excision ; Male ; Middle Aged ; Prophylactic Surgical Procedures ; methods ; Stomach Neoplasms ; surgery ; Treatment Outcome ; Young Adult