[Objective] To explore the temperature parameters affecting the polybrene test and determine the optimal temperature conditions for detecting unexpected antibodies of the Rh system. [Methods] The reaction of IgG human anti-D antibody with different dilutions (undiluted, 1∶2, 1∶4, 1∶8, 1∶16, 1∶32，1∶64) with D antigen-positive red blood cells was detected by manual polybrene test (MPT). Different temperatures (25℃ and 37℃) were set, and the reaction time with low ionic medium was 4 minutes. The agglutination integral value of anti-D and red cell depolymerization time were compared to observe the effect of enhanced agglutination reaction, thereby establishing the test temperature reaction conditions for enhancing the MPT. The same reaction condition was applied to 36 blood samples containing unexpected antibodies of the Rh system, and the effect of enhanced MPT was observed in comparison with the polybrene method and the antiglobulin test (column agglutination). [Results] With all other conditions held constant, when low ionic medium was added, the incubation temperature of 25℃ and 37℃ resulted in different total agglutination integral values for anti-D (20.9±2.025 vs 25.5±2.635), and the comparison showed a significant difference (P<0.05). When the antibody dilution was 1∶16, the incubation temperature of 25℃ and 37℃ resulted in different agglutination integral values (3.9±0.738 vs 5.8±0.632), and the comparison showed a significant difference (P<0.05). Erythrocyte depolymerization time (62.8±8.149 vs 90.1±10.713) was significantly different (P<0.05). At a dilution of 1∶32, the incubation temperatures of 25℃ and 37℃ resulted in different agglutination integral values (2.5±0.527 vs 4.3±0.675), as well as different red blood cell dissociation times (35.4±7.792 vs 57.4±10.885)(P<0.05), and the comparison showed a significant difference (P<0.05), with no differences observed in the other groups. In the detection of 36 Rh system unexpected antibody samples, when the antibody titer was ≤2, the enhanced polybrene method had a higher positive rate, and when the antibody titer was ≥4, the detection rates of the three methods were consistent. [Conclusion] The reference temperature condition for the modified MPT is incubation at 37℃ for 4 min after the addition of low ionic medium. The application of this temperature condition to unexpected antibody samples of Rh system could achieve a significant enhancement effect, thereby increasing transfusion safety for the treatment of emergency patients, and is worth popularizing.

Objective To understand and analyze the epidemiological and pathogenic characteristics of foodborne diseases in Changzhou in the past five years, so as to provide evidence for prevention and control measures. Methods All foodborne disease surveillance information reported by Changzhou foodborne disease sentinel hospital from 2016 to 2020 was collected through the ^“Foodborne Disease Surveillance and Reporting System^”. The distribution of reported cases and etiological results was described, and the possible factors affecting pathogen detection results were analyzed. Results A total of 14 931 cases of foodborne diseases were reported, mainly distributed in summer and autumn, and peaked in July and August. The age group of reported cases was 25-34 years old, and the occupations were mainly workers, and farmers and migrant workers, accounting for 23.2% and 36.9%, respectively. Among the reported cases of 3 120 anal swabs were collected and tested for etiology , of which 291 specimens were positive, with a positive detection rate of 9.32%. Among the 291 positive results of 118 cases of norovirus were detected, with a detection rate of 6.03% . 66 cases of salmonella were detected, with a detection rate of 2.12% . 25 cases of vibrio parahaemolyticus were detected, with a detection rate of 0.80% . 7 cases of diarrhea-causing Escherichia coli was detected, with a detection rate of 0.22% ; and 5 cases of shigella was detected, with a detection rate of 0.16% . Single factor analysis of the results of pathogen detection showed that there were no statistical differences in the distribution of positive pathogen detection rate between males and females, and between different suspicious exposed foods (all P>0.05). There were statistical differences in different age groups, occupations, seasons and eating places (all P<0.05). Multivariate Logistic regression analysis showed that age and season were correlated with the detection rates of pathogenic microorganisms (all P<0.05) , and age was negatively correlated with the positive rate of pathogenic microorganisms (OR=0.863). The detection rates in the first and fourth quarters were higher than those in the second and third quarters. Conclusion Summer and autumn are the seasons with high incidence of foodborne diseases in Changzhou. Norovirus is the main pathogen. Age and season are closely related to the detection results of pathogenic microorganisms. Comprehensive prevention and control measures should be implemented for key population in summer and autumn to reduce the occurrence and outbreak of foodborne diseases.

Background With the increasing exposure to hazardous chemicals in the workplace and frequency of occupational injuries and occupational safety accidents, the acquisition of occupational exposure limits of hazardous chemicals is imminent. Objective To obtain more unknown immediately dangerous to life or health (IDLH) concentrations of hazardous chemicals in the workplace by exploring the application of quantitative structure-activity relationship (QSAR) prediction method to IDLH concentrations, and to provide a theoretical basis and technical support for the assessment and prevention of occupational injuries. Methods QSAR was used to correlate the IDLH values of 50 benzene and its derivatives with the molecular structures of target compounds. Firstly, affinity propagation algorithm was applied to cluster sample sets. Secondly, Dragon 2.1 software was used to calculate and pre-screen 537 molecular descriptors. Thirdly, the genetic algorithm was used to select six characteristic molecular descriptors as dependent variables and to construct a multiple linear regression model (MLR) and two nonlinear models using support vector machine (SVM) and artificial neural network (ANN) respectively. Finally, model performance was evaluated by internal and external validation and Williams diagram was drawn to determine the scopes of selected models. Results The ANN model results showed that \begin{document}$ {R}_{\mathrm{t}\mathrm{r}\mathrm{a}\mathrm{i}\mathrm{n}}^{2} $\end{document}=0.8526 and \begin{document}$ {R}_{\mathrm{t}\mathrm{e}\mathrm{s}\mathrm{t}}^{2} $\end{document}=0.8505 respectively, root mean square (RMSE) error=0.5243, mean absolute error (MAE)=0.4610, internal and external validation coefficients \begin{document}$ {Q}_{\mathrm{l}00}^{2} $\end{document}=0.8476 and \begin{document}$ {Q}_{\mathrm{e}\mathrm{x}\mathrm{t}}^{2} $\end{document}=0.8905 respectively. By comparison, the performance verification parameters of the ANN model were superior to the MLR and SVM models, and all substances were in the applicable domain. Conclusion At present, the ANN model has the best performance in fitting ability, stability, and prediction, and is suitable for predicting IDLH concentrations of benzene and its derivatives. Predicting the IDLH concentraitons of benzene and its derivatives by QSAR method is an effective method, and provides a theoretical basis and technical support for the development of occupational health and safety.

Objective To understand the contamination status of common food-borne pathogens in foods sold in Changzhou, and to provide evidence for food safety risk assessment and prevention of food-borne diseases. Methods From 2010 to 2020 , 2 513 samples of 17 types of foods were collected in Changzhou area. The detection of pathogenic bacteria was carried out in accordance with the standard operation procedure specified in the ^“Workbook for Surveillance on Food Microorganisms and Pathogenic Factors in Jiangsu Province^”. Results A total of 260 positive samples of common food-borne pathogens were detected in all 2 513 samples with an overall detection rate of 10.30%. Single factor analysis showed that the detection rate of pathogenic bacteria in non-ready-to-eat samples was higher than that in ready-to-eat samples (χ²=148.875，P =0.000). The detection rate of pathogenic bacteria in bulk samples was higher than that in prepackaged ones (χ²=70.956，P=0.000). There is a difference in the detection rate of food-borne pathogens from different types of sampling sites (χ²=65.017，P=0.000). Logistic regression analysis showed that ready-to-eat food, packaging type, and sampling season were significantly correlated with the detection rate of food-borne pathogens. The detection rate of pathogenic bacteria in samples collected in the third or fourth quarters was higher than that in the first quarter. Conclusion The commercial foods sold in Changzhou have a relatively high level of contamination of food-borne pathogenic bacteria, and they should be fully heated and sterilized before consumption. The relevant departments should strengthen supervision and health education in summer and autumn.

OBJECTIVE To optimize the clinical drug list of diagnosis-related group （DRG）， reduce the drug cost of patients， and increase the DRG settlement rate. METHODS By selecting BR23 disease group in the department of neurology of a hospital as the research object， data mining technology was used to explore the medication rule of the disease group， and the key monitored drugs were scored by comprehensive evaluation of drugs， thus optimizing the clinical drug list of disease groups. The hospitalization information of patients enrolled in the disease group in December 2022 was selected as the pre-optimization data， and the hospitalization information of patients enrolled in the disease group in September 2023 was selected as the post-optimization data. The implementation effect of the optimized list was evaluated by comparing the medical quality and drug cost data between the two groups. RESULTS After optimizing the clinical drug list， the settlement rate of this disease group increased from 84.36% before optimization to 104.70%； there was significant reduction in hospitalization drug cost and total hospitalization cost （P＜ 0.05）； the consumption of key monitored drugs significantly decreased. CONCLUSIONS Data mining technology helps explore the clinical medication rules of disease groups， which can be used by pharmacists to improve the settlement rate of DRG through effective pharmaceutical intervention.

Objective To evaluate the clinical significance of transvaginal color Doppler ultrasound for the differential diagnosis of benign and malignant ovarian cysts. Methods Patients who were diagnosed with clinically suspected or palpable adnexal masses and underwent gray-scale ultrasonography, transvaginal color Doppler ultrasonography, and ultrasound-guided fine-needle aspiration cytology (FNAC) during the period from 2018 to 2021 were enrolled in this study. The pulsatility index (PI) and resistance index (RI) were estimated, and an ovarian cyst with the lowest PI value of < 1.0 or the lowest RI value of < 0.4 was considered as malignant. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of gray-scale ultrasound and transvaginal color Doppler ultrasound for the differential diagnosis of benign and malignant ovarian cysts were estimated with FNAC as the gold standard. Results A total of 180 patients with ovarian cysts were recruited, and FNAC revealed that 81 of them had malignant lesions and 99 of them had benign lesions. The transvaginal color Doppler ultrasonograms showed that 75 patients (92.59%) with malignant lesions had blood-flow signals in their cysts and 42 patients (42.24%) with benign lesions had blood-flow signals in their cysts, with a significant difference in the proportion between the two groups (χ² = 49.29, P < 0.01). Among the 75 patients with blood-flow signals in malignant ovarian cysts, 75 had PI < 1.0 and 24 had RI < 0.4; among the 42 patients with blood-flow signals in benign ovarian cysts, 15 had PI < 1.0 and no one had RI < 0.4; there were significant differences in the proportions of PI < 1.0 and RI < 0.4 between the two groups (χ² = 62.68, P < 0.01; χ² = 16.91, P < 0.01). In addition, compared with the combination of gray-scale ultrasound and transvaginal color Doppler ultrasound, gray-scale ultrasound alone had significantly lower sensitivity (51.85% vs 81.48%; χ² = 16.00, P < 0.01), specificity (75.76% vs 93.94%; χ² = 12.73, P < 0.01), PPV (63.64% vs 91.67%; χ² = 15.90, P < 0.01), and NPV (65.79% vs 86.11%; χ² = 12.44, P < 0.01) for the differential diagnosis of benign and malignant ovarian cysts. Conclusion Gray-scale ultrasound is effective for diagnosing ovarian cysts; however, gray-scale ultrasound combined with transvaginal color Doppler ultrasound can improve the differential diagnosis of benign and malignant ovarian cysts.

Objective To understand the water quality and sanitation of swimming pools in Changzhou City, provide a basis for the sanitation supervision of swimming places by the sanitation supervision department, and protect the health of swimmers. Methods The water samples (pool water and foot immersion water) of Changzhou swimming pool from June to August of 2018-2020 were randomly collected and tested according to the Examination Methods for Public Places-Part 6: Technical Specifications of Health Monitoring (GB/T 18204.6-2013). The evaluation of test result was based on the Hygienic Standard for Swimming Place (GB 9667-1996) and Hygienic Indicators and Limits for Public Places (GB 37488-2019). SPSS19.0 statistical software was used, and the data was analyzed by chi-square test. Results Total 94 swimming places and 178 water samples were tested from 2018 to 2020. 40 samples achieved standard (22.47%). There was no statistically significant difference in water qualified rates quality qualification rate between 2018, 2019 and 2020 (χ²=5.42, P=0.07). The main unqualified items were free residual chlorine (46.63%), followed by urea (76.40%) and total bacteria count (78.09%). Conclusion The water quality of swimming pools in Changzhou is still poor, and the daily supervision of swimming pools should continue to be strengthened.

Objective To examine the value of breast ultrasound for diagnosis of benign and malignant breast masses among female patients with nipple discharges, and to provide a reference for the diagnosis of patients with nipple discharges. Methods A total of 317 female patients with nipple discharges underwent breast examinations in Changzhou Maternal and Child Health Care Hospital between April 2021 and May 2024 were enrolled, and all patients underwent ultrasound, mammography, and pathologic examinations of the breast. With pathologic examination as the gold standard, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of breast ultrasound and mammography for diagnosis of benign and malignant breast masses were compared. The diagnostic value of breast ultrasound for benign and malignant breast masses was evaluated among female patients with nipple discharges. Results The study subjects had a mean age of (43.27 ± 10.71) years, and a mean nipple discharge duration of (1.11 ± 0.53) years. Moreover, 51.74% of nipple discharges were in the right-sided breast, 52.05% were spontaneous, 32.49% were bloody, and 53.63% were classified as Breast Imaging Reporting and Data System category 1 to 3. Of the 317 female patients with nipple discharges, histopathology detected 137 malignant breast masses and 180 benign masses, and the 53 masses with Breast Imaging Reporting and Data System category 5 were all malignant. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 64.23%, 77.22%, 68.22%, 73.94% and 71.61% for breast ultrasound, and 80.29%, 35.00%, 48.46%, 70.00% and 54.57% for breast mammography. The specificity (χ²=8.81, P < 0.01), positive predictive value (χ²=13.01, P < 0.01), and accuracy (χ²=19.75, P < 0.01) of breast ultrasound were significantly higher than breast mammography, while the sensitivity of breast ultrasound was significantly lower than breast mammography (χ²=65.15, P < 0.01). However, there was no significant difference in the negative predictive value between breast ultrasound and mammography (χ²=0.47, P > 0.05). Conclusion Breast ultrasound has a high accuracy for diagnosis of benign and malignant breast masses among female patients with nipple discharges, which may serve as an auxiliary tool for diagnosis of breast masses among patients with nipple discharges.

Objective To assess the state of schistosomiasis elimination in 6 districts of Changzhou City, Jiangsu Province, so as to provide the evidence for the formulation of consolidation measures. Methods Three towns (streets) were selected according to the schistosomiasis epidemic degree in each district, and one village was sampled from each town. The on-site assessment was carried out between 2016 and 2017, including Oncomelania hupensis snail survey, population investigation and domestic animal investigation. In addition, the related data and materials were evaluated and the monitoring ability was assessed. Results In the history, there were 54 endemic towns, 368 endemic villages in Changzhou City, with a total area of 3 934.79 hm² of historic snail spots, and 114 990 schistosomiasis cases so far. In the field assessment in 6 districts, a total of 26 environments were surveyed, with the surveyed area of 36.23 hm², and there were no living snails captured in each village. A total of 18 199 people were examined for schistosome infection, 255 were blood test positive, and the sero-positive rate was 1.40%. The stool examination was done in 255 sero-positive cases, and no cases were stool-positive. A total of 779 domestic animals were investigated, including 200 cattle, 179 sheep and 400 pigs, and no infections were detected. The files regarding the snail status and schistosomiasis epidemic situation, and the monitoring data were complete and accurate in 6 districts. The annual investment funds for schistosomiasis prevention were 3 120 000 Yuan in Changzhou City, and the number of staff working for schistosomiasis prevention was 86 totally, which could meet the requirements of high quality monitoring. Conclusions All 6 districts of Changzhou City have met the requirements of schistosomiasis elimination.