OBJECTIVE To evaluate the capabilities of nosocomial infection control in local general hospitals in handling public health emergencies,and to provide reliable data for future work.METHODS A random sampling questionnaire method was adopted to investigate how nosocomial infection control in local hospitals performed their functions and handled public health emergencies.RESULTS The 15 hospitals which were surveyed had all been equipped with computer network of directly reporting epidemic situations of infectious diseases.Four from 15 hospitals had full-time employees reporting epidemic situations,and 11 had part-time employees.Twelve hospitals established,according to standards,a department of infectious diseases or a department of pre-examination and sorting diagnosis.Seven hospitals did not have full-time staff of infection control till 2003.The rate of the staff's knowledge of nosocomial infection control was 73.7%.The medical wastes of the 15 hospitals were all disposed at the local medical waste disposal center.CONCLUSIONS Our city,in terms of nosocomial infection control,has acquired certain capabilities of handling public health emergencies.But the capabilities vary from hospital to hospital.Further improvement in some work is still needed.

Objective To analyze the clinical and electroencephalogram (EEG) characteristics as well as its evolutionary process of Dravet syndrome (DS) in order to improve early diagnosis and appropriate treatment.Methods Fifty patients with DS were studied including onset age, trigger factors, seizure types on different age stages and relationship with EEG characteristics and its evolution process.Results The average age of seizure onset was ( 5.5 ± 1.9 ) months.The fever sensitivity continuously existed in the entire course of disease.In the early stage, generalized tonic-clonic seizures (GTCS) and focal or unilateral seizures were main types.Multi seizure types included myoclonic seizures (MS) and atypical absence occurred later.The onset ages of MS were average (M50) of 16 months.MS never occurred in 26% of the patients.During the first year of life, EEGs were normal in 76% of these patients.The epileptiform discharges only recorded in about 50% of the patients in spite of multi seizure types had presented.After three years ago, both EEG background abnormalities and discharges occurred in more 90% of the all patients.Photosensitivity response with MS occurred in the 28% of 18 patients.Conclusions The clinical and EEG are not parallel progressively process in early stage of DS.The children often express more severe clinical seizures than EEG abnormalities until 2 years of age.Various abnormal EEG manifestation obviously display gradually after 3 years age.Precise recognizing with the clinical and EEG characteristics of DS will help get correct early diagnosis and screen the candidate cases to test SCN1A gene.

Objective: By comparing different repairing effects of different methods on articular cartilage defects in rabbit model, the ability of a new bioactive glass scaffold to repair cartilage defect was studied. Methods: We prepared the PSC/CS bone cement by mixing the bioactive glass (BG) powder composed of 10.8%P₂O₅-54.2%SiO₂-35%CaO (PSC), chitosan solution (CS) and calcium sulfate hemihydrate (CSH), then the bone cement was sized by a mold to form cylindrical scaffold. In vivo experiment, 18 male rabbits were divided into three groups randomly, including blank group, BG group and TGF-β1 group, which was added TGF-β1 into BG scaffold. Both knees of each rabbit were made cartilage defect for the same group, and no intervention was applied in B group, then implanted scaffolds into defects in both experimental groups. At 6 and 12 weeks after surgery, observed the macroscopic growth, histologic staining and collagen II immunohistochemistry (IHC), and the International Cartilage Repair Society (ICRS) and Wakitani score were used to analyze the experimental results quantitatively. Results: At 6 weeks after surgery, there was no obvious difference between blank group and BG groups, but the macroscopic result of TGF-β1 group was better than the other two groups and its ICRS score 4.67±0.52 points was statistically higher than BG group 2.83±0.75 points (t=-2.817, P=0.015). As to the comparison of histologic staining and Wakitani socre among three groups, no statistical difference was observed (blank group=13.67±0.52, BG group=13.83±0.41, TGF-β1 group=13.33±1.03). At 12 weeks after surgery, there was still no obvious difference between blank and BG groups, while the results of macroscopic observation and ICRS score in TGF-β1 group were significantly higher than them 9.01±0.63 points (blank group vs TGF-β1 group: t=-2.289, P=0.022; BG group vs TGF-β1 group: t=-2.326, P=0.020). More importantly, much deeper positive staining were observed in TGF-β1 group, and the Wakitani score was higher than the other two groups (blank group=9.83±1.33, BG group=9.51±1.05, TGF-β1 group=6.50±1.38, blank group vs TGF-β1 group: t=-2.771, P=0.007; BG group vs TGF-β1 group: t=-2.756, P=0.006). By comparing the degree of histologic staining and Col II expression with normal cartilage, the regenerated tissue in TGF-β1 group was similar. Conclusion Single PSC/CS scaffold doesn’t possess excellent ability to repair cartilage defect. When TGF-β1 was added into PSC/CS bioactive glass, the scaffold was able to promote cartilage defect repair, and the regenerated tissue was similar to normal cartilage.

Post-stroke depression (PSD) can seriously affect the outcome and quality of life of patients with stroke. However, due to the lower diagnostic rate, a large number of patients with PSD have not been treated in time and have a poor outcome. Therefore, only early detection, early diagnosis and early treatment of PSD can improve the prognosis and quality of life of patients with stroke. In recent years, a large number of studies on serum biomarkers have tried to find objective indicators related to PSD. Among them, interleukin-18 is associated with the pathogenesis of stroke and PSD, which may be attributed to its polymorphism and constitutive expression in the brain, especially the role of serum level changes in the risk stratification and outcome of acute ischemic stroke. This article reviews the role of interleukin-18 in the pathogenesis of PSD.

Objective: To explore the impact of tennis on the visual health of primary school students, so as to provide a basis for myopia prevention. Methods: In September 2021, a total of 202 third grade students from Fengtai Affiliated School of Renmin University of China in Beijing were recruited, with 75 students in the intervention group and 127 students in the control group. In addition to attending the same cultural and physical education courses, the intervention group added a tennis course twice a week and tested their vision before the intervention (September 2021), middle (January 2022) and later (June 2022). Data collected at different time points in the two groups were analyzed by using independent sample t-test for comparison between blocks, and single factor repeated measurement ANOVA for analysis of time point factors. Results: After intervention, among male subjects, the average visual acuity of the left and right eyes in the intervention group were higher than that in the control group at the third visual acuity test (left eye:5.00±0.13,4.88±0.29, right eye:5.00±0.12,4.88±0.30, t =2.33, 2.36, P <0.05). Among female subjects, the second visual acuity test (left eye:5.03±0.17, 4.86±0.21, right eye:5.03±0.15, 4.85±0.23) and the third visual acuity test (left eye:4.97±0.13, 4.81±0.23, right eye:4.97±0.14, 4.82±0.24) showed that the average visual acuity of the left and right eyes in the intervention group were higher than that in the control group among females (second: t =3.84, 3.87, third: t =3.70, 3.46, P < 0.01 ). After intervention, the detection rate of visual impairment in both males and females control groups increased at three tests, with statistically significant differences ( χ 2=17.86, 34.77, P <0.01). In the first visual acuity test, there was no statistically significant difference in the detection rate of visual impairment between the control group and the intervention group for both males and females ( χ 2=0.01, 0.10, P >0.05). The third visual impairment detection rate of males in the intervention group was lower than that of the control group (20.00% vs 45.45%), while the second and third visual impairment detection rates of female students in the intervention group were lower than those of the control group (22.86% vs 54.00%; 28.57% vs 70.00%) ( χ 2=7.34, 8.24, 14.18, P < 0.01). Conclusions Tennis can alleviate and prevent the occurrence of myopia in primary school students to a certain extent. Sports such as tennis should be actively promoted to protect the visual health of primary school students.

Objective To investigate the value of renal CT volumetric texture analysis with machine learning radiomics in assessment of pathological grade of clear cell renal cell carcinoma(ccRCC). Methods Thirty-four biopsy-confirmed ccRCC subjects who had four-phase CT scanning (NC:non-contrast, CM: Corticomedullary, N: Nephrographic, E: Excretory) were collected retrospectively from June 2013 to October 2017 for the study.Non-rigid registration was performed on multi-phase CT images in reference to CM-phase.Each lesion was segmented on CM-phase CT images using our in-house volumetric image analysis platform,"3DQI".A set of fifty-nine volumetric textures,including histogram,gradient,gray level co-occurrence matrix(GLCM),run-length(RL),moments,and shape,was calculated for each segment lesion in each phase as parameters for the training/testing of Random Forest (RF) classifier. Four groups according to pathological Fuhrman grade on a scaleⅠtoⅣ,these tumors were then divided into low(Ⅰ+Ⅱ) and high grade ( Ⅲ + Ⅳ) groups. Feature selection was performed by Boruta algorithm. A 10-fold cross-validation method was applied to validate the RF performance by receiver operating characteristic (ROC) curves analysis to determine the diagnostic accuracy of the model. Results Subjects were divided into four groups by Fuhrman grade on a scaleⅠtoⅣ:3 cases gradeⅠ,19 cases gradeⅡ,8 cases gradeⅢand 4 cases gradeⅣ.In CM-phase,kurtosis and long-run-emphasis(RLE)were selected the most important textures for ccRCC staging among 59 features. The area under curve (AUC) of ROC was 0.88 (79% sensitivity and 82% specificity)by using kurtosis and RLE textures.The mean values of kurtosis and RLE were(-20.00±22.00)×10-2and(3.00±0.40)×10-2for low group,whereas(31.00±32.00)×10-2and(5.00± 0.02)×10-2for high group.Within the mean±SD range of statistics,radiomics can distinguish between low and high grade tumors.In multi-phase analysis,three most important features were selected among 236(59× 4) textures: kurtosis (CM-phase), GLCM homogeneity I (HOMO 1) (E-phase), and GLCM homogeneity 2 (HOMO2)(E-phase).The mean values of HOMO 1(E-phase)and HOMO 2(E-phase)were(19.00±0.03)× 10-2and(11.00±0.02)×10-2for low group,whereas(22.00±0.03)×10-2and(14.00±0.02)×10-2for high group. The AUC was 0.92(93% sensitivity and 87% specificity)by using these three textures. Conclusion This study has demonstrated that renal CT volumetric texture analysis with machine learning radiomics could preoperative accurately perform cancer staging for ccRCC.

Objective:To explore the influence of patient participation-based dietary intervention on nutritional status for patients with severe burn.Methods:From September 2017 to January 2019, 60 severe burn patients hospitalized in the department of burn and plastic surgery of Qingdao Municipal Hospital were recruited and divided into the experimental group ( n=30) and the control group ( n=30) according to the random number table method. The control group received a regular diet. While the experimental group received a patient participation-based dietary intervention(PPDI), The wound healing time and the value of nutritional status index, such as height, body mass index(BMI), serum albumin, serum prealbumin, in the two groups on admission, at 2 weeks after intervention, 4 weeks after intervention were compared. The nutritional knowledge questionnaire of burn patients and "3-day diet diary" were used for investigation. Results:The score of nutritional knowledge showed no significant difference between the two groups before intervention. After intervention, the score of nutritional knowledge in the experimental group was 21.40±2.42, significantly higher than that in the control group (19.00±2.26) ( t value was 3.975, P<0.01). For time effect and between-group effect, there were significant difference in serum albumin between two groups ( F values were 9.232, 4.651, P<0.05); the time effect and between-group effect of serum prealbumin were statistically significant ( F values were 11.592, 6.228, P < 0.05). The wound healing time in the experimental group was significantly lower than that in the control group ( t value was -3.801, P<0.01). Conclusions:Patient participation-based dietary intervention can effectively enhanced the level of nutritional knowledge, improved nutritional status, shortened wound healing time among patients with severe burn.

Background/Aims: The accuracy of endosonographers in diagnosing gastric subepithelial lesions (SELs) using endoscopic ultrasonography (EUS) is influenced by experience and subjectivity. Artificial intelligence (AI) has achieved remarkable development in this field. This study aimed to develop an AI-based EUS diagnostic model for the diagnosis of SELs, and evaluated its efficacy with external validation. Methods: We developed the EUS-AI model with ResNeSt50 using EUS images from two hospitals to predict the histopathology of the gastric SELs originating from muscularis propria. The diagnostic performance of the model was also validated using EUS images obtained from four other hospitals. Results: A total of 2,057 images from 367 patients (375 SELs) were chosen to build the models, and 914 images from 106 patients (108 SELs) were chosen for external validation. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the model for differentiating gastrointestinal stromal tumors (GISTs) and non-GISTs in the external validation sets by images were 82.01%, 68.22%, 86.77%, 59.86%, and 78.12%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in the external validation set by tumors were 83.75%, 71.43%, 89.33%, 60.61%, and 80.56%, respectively. The EUS-AI model showed better performance (especially specificity) than some endosonographers.The model helped improve the sensitivity, specificity, and accuracy of certain endosonographers. Conclusions We developed an EUS-AI model to classify gastric SELs originating from muscularis propria into GISTs and non-GISTs with good accuracy. The model may help improve the diagnostic performance of endosonographers. Further work is required to develop a multi-modal EUS-AI system.

Objective To analyze the hemodynamic parameters of anomalous origin of the right coronary artery from the left coronary artery sinus (AORL) based on computational fluid dynamics (CFD), so as to make an evaluation of the disease. Methods A normal right coronary artery (RCA) case and an AORL case were selected. Two models were reconstructed in Mimics software and imported into ANSYS CFX software for hemodynamics simulation. The hemodynamics of normal RCA model and AORL model were compared. Results AORL model had a smaller volume flow (9.35 cm3/s), which might lead to insufficient blood supply downstream of the RCA; the pressure at the acute corner of AORL model (13.78 kPa) was lower than normal RCA model (14.9 kPa); the wall shear stress (WSS) of AORL model (12.83 Pa) was larger than that of normal RCA model (9.74 Pa); the total deformation of AORL model was relatively large. Conclusions The entrance velocity and pressure of AORL were lower than those of normal RCA, which might lead to ischemic symptoms. The research findings are of theoretical significance for the effective evaluation of ischemia and other diseases in clinic.