OBJECTIVE T o analyze the current situation and characteristics of hospital-associated infection in a psy-chiatric hospital,providing references for formulation of control measures for hospital-associated infection.METHODS A retrospective analysis was conducted on hospital-associated infection data from Shanghai Mental Health Center between Jan.1,2019,and Oct.31,2024.The infection rates and infection sites across different years,patient populations,and departments were analyzed.RESULTS A total of 47 051 inpatients were investiga-ted,with 1 798 cases of hospital-associated infections,resulting in an infection rate of 3.82％.The highest inci-dence rate was observed in 2020(4.13％).The top three departments with the highest incidence rates were the in-fectious disease department(12.13％),geriatric psychiatry(7.67％),and the Traditional Chinese Medicine De-partment department(4.90％).The primary infection sites were the lower respiratory tract(57.06％),urinary tract(18.24％),skin and soft tissue(14.29％).The incidence rate was higher in males(5.32％)than in females(2.72％)(P＜0.001).Statistically significant differences were found in the incidence rates among different age groups(P＜0.001),with the highest rate observed in patients aged over 90 years(17.11％).The lowest infection rate was found in patients hospitalized for less than 60 days(0.69％),while the highest was in those hospitalized for more than 1 000 days(49.94％).CONCLUSIONS The patients in psychiatric hospitals are susceptible to infec-tions in the respiratory tract,urinary tract,skin and soft tissue.Targeted prevention and control measures can be implemented based on high-risk factors such as age,length of stay,and gender to reduce the occurrence of in-fections.

OBJECTIVE T o analyze the current situation and characteristics of hospital-associated infection in a psy-chiatric hospital,providing references for formulation of control measures for hospital-associated infection.METHODS A retrospective analysis was conducted on hospital-associated infection data from Shanghai Mental Health Center between Jan.1,2019,and Oct.31,2024.The infection rates and infection sites across different years,patient populations,and departments were analyzed.RESULTS A total of 47 051 inpatients were investiga-ted,with 1 798 cases of hospital-associated infections,resulting in an infection rate of 3.82％.The highest inci-dence rate was observed in 2020(4.13％).The top three departments with the highest incidence rates were the in-fectious disease department(12.13％),geriatric psychiatry(7.67％),and the Traditional Chinese Medicine De-partment department(4.90％).The primary infection sites were the lower respiratory tract(57.06％),urinary tract(18.24％),skin and soft tissue(14.29％).The incidence rate was higher in males(5.32％)than in females(2.72％)(P＜0.001).Statistically significant differences were found in the incidence rates among different age groups(P＜0.001),with the highest rate observed in patients aged over 90 years(17.11％).The lowest infection rate was found in patients hospitalized for less than 60 days(0.69％),while the highest was in those hospitalized for more than 1 000 days(49.94％).CONCLUSIONS The patients in psychiatric hospitals are susceptible to infec-tions in the respiratory tract,urinary tract,skin and soft tissue.Targeted prevention and control measures can be implemented based on high-risk factors such as age,length of stay,and gender to reduce the occurrence of in-fections.

AIM:To investigate whether the expression of perilipin 2(PLIN2)in renal tubular cells could predict a decline in renal function in diabetic kidney disease(DKD)patients,and to explore the potential mechanisms in-volved in renal tubular cell injury induced by PLIN2 during the progression of DKD.METHODS:Control individuals(n=12)and DKD patients(n=51)were enrolled in this retrospective cohort study.Demographic and laboratory data were col-lected.A simplified linear mixed-effects model was applied to assess the estimated glomerular filtration rate(eGFR)slope.The relationship between PLIN2 and renal function decline in DKD patients was predicted by Spearman correlation analysis and a generalized linear model.BKS-db/db diabetic mice and streptozotocin-induced diabetic mice were used.Primary renal tubular cells were treated with glucose and transfected with small interfering RNA or plasmid.Western blot-ting and immunofluorescence staining were used to detect PLIN2 expression.Lipid droplets were stained with oil red O.The oxygen consumption rate(OCR)of mitochondria was measured using an extracellular flux analyser.RESULTS:The expression of PLIN2 was markedly higher in the tubules of DKD patients than in those of control subjects.After 24(12,39)months of follow-up,the eGFR slope of DKD patients was-7.42(-19.77,-2.09)mL/(min·1.73 m2·year).An in-crease in the baseline percentage of PLIN2-positive tubules was significantly associated with the eGFR slope during the fol-low-up period[hazard ratio(HR)=1.90,95%confidence interval(CI):1.00～3.58],indicating that tubular PLIN2 could predict a decrease in renal function in DKD patients.Both the accumulation of lipid droplets and the expression of PLIN2 were markedly greater in the tubules of diabetic mice than in those of control mice.Glucose treatment induced lipid droplet accumulation and PLIN2 expression in renal tubular cells.Knockdown of PLIN2 significantly alleviated glucose-in-duced lipid droplet accumulation,whereas PLIN2 overexpression aggravated glucose-induced lipid droplet accumulation.The decrease in mitochondrial OCR in renal tubular cells induced by glucose treatment was alleviated after PLIN2 knock-down.However,overexpression of PLIN2 directly decreased the mitochondrial OCR.CONCLUSION:The PLIN2 ex-pression in tubules predicts a decline in renal function in patients with DKD.The PLIN2 suppresses mitochondrial aerobic respiration and contributes to the accumulation of lipid droplets in renal tubular cells to promote the progression of DKD.

Objective:To construct a clinical benefit evaluation model of medical equipment based on the combination weighting of game theory with cloud model,so as to improve the clinical service capability and operational quality of medical equipment. Methods:The game theory,combination weighting and cloud model were used to scientifically empower and comprehensively evaluate 13 clinical benefit evaluation indexes from 3 dimensions:direct input,direct output. and indirect benefits of medical equipment,and to develop corresponding equipment management strategies.. 47 large medical equipment in clinical use at Taizhou People's Hospital from 2022 to 2023 were selected,and the large medical equipment used in 2022 was subjected to subjective evaluation management. The equipment used in 2023 adopts a medical device clinical benefit evaluation model (referred to as model evaluation management) of game theory combination weighting and cloud model to carry out clinical benefit evaluation and management of the equipment. The clinical benefit,operation quality and management level of the two management methods were compared. Results:The effective management rate of medical equipment using the model evaluation management method was 63.83％(30/47),which was higher than that using the subjective evaluation management method,and the difference was statistically significant (x2=5.158,P<0.05). The average clinical risk rate,failure rate and detection failure rate of medical equipment using the model evaluation management method were (10.59±3.09)‰,(7.27±3.53)‰ and (12.06±2.43)‰,respectively,all of which were lower than those obtained through the subjective evaluation management method. The differences were statistically significant (Z=3.783,2.748,3.928,P<0.05). The assessment scores of medical equipment use managers on the ability of equipment use,maintenance,repair and planning using the model evaluation management method were (93.38±3.73) points,(94.05±3.14) points,(92.61±3.44) points and (94.88±2.50) points,respectively,which were higher than those obtained through the subjective evaluation management method. The differences were statistically significant (Z=2.718,3.036,3.039,3.929,P<0.05). Conclusion:The application of the clinical benefit evaluation model of medical equipment,which based on the game theory combination weighting and cloud model,can accurately evaluate the clinical benefit level of medical equipment,and improve the operation quality of the equipment,and enhance the management level of equipment.

Objective:To construct a clinical benefit evaluation model of medical equipment based on the combination weighting of game theory with cloud model,so as to improve the clinical service capability and operational quality of medical equipment. Methods:The game theory,combination weighting and cloud model were used to scientifically empower and comprehensively evaluate 13 clinical benefit evaluation indexes from 3 dimensions:direct input,direct output. and indirect benefits of medical equipment,and to develop corresponding equipment management strategies.. 47 large medical equipment in clinical use at Taizhou People's Hospital from 2022 to 2023 were selected,and the large medical equipment used in 2022 was subjected to subjective evaluation management. The equipment used in 2023 adopts a medical device clinical benefit evaluation model (referred to as model evaluation management) of game theory combination weighting and cloud model to carry out clinical benefit evaluation and management of the equipment. The clinical benefit,operation quality and management level of the two management methods were compared. Results:The effective management rate of medical equipment using the model evaluation management method was 63.83％(30/47),which was higher than that using the subjective evaluation management method,and the difference was statistically significant (x2=5.158,P<0.05). The average clinical risk rate,failure rate and detection failure rate of medical equipment using the model evaluation management method were (10.59±3.09)‰,(7.27±3.53)‰ and (12.06±2.43)‰,respectively,all of which were lower than those obtained through the subjective evaluation management method. The differences were statistically significant (Z=3.783,2.748,3.928,P<0.05). The assessment scores of medical equipment use managers on the ability of equipment use,maintenance,repair and planning using the model evaluation management method were (93.38±3.73) points,(94.05±3.14) points,(92.61±3.44) points and (94.88±2.50) points,respectively,which were higher than those obtained through the subjective evaluation management method. The differences were statistically significant (Z=2.718,3.036,3.039,3.929,P<0.05). Conclusion:The application of the clinical benefit evaluation model of medical equipment,which based on the game theory combination weighting and cloud model,can accurately evaluate the clinical benefit level of medical equipment,and improve the operation quality of the equipment,and enhance the management level of equipment.

Objective: First-line bevacizumab plus carboplatin and paclitaxel (CP) is approved for stage III/IV ovarian cancer treatment following initial surgical resection, based on global phase III GOG-0218 and ICON7 trials. This study evaluated the efficacy and safety of bevacizumab + CP as first-line ovarian cancer therapy in Chinese patients. Methods: Patients with newly diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV epithelial ovarian, fallopian tube, or primary peritoneal cancer post-primary surgery were randomized 1:1 to receive 6 cycles of CP with bevacizumab/ placebo, followed by bevacizumab/placebo maintenance until unacceptable toxicity or disease progression. Primary endpoint was investigator-assessed progression-free survival (PFS). Stratification factors were FIGO stage and debulking status (stage III optimally debulked vs stage III suboptimally debulked vs stage IV) and Eastern Cooperative Oncology Group performance status (0 vs 1 or 2). Results: Of randomized patients, 51 received bevacizumab + CP and 49 received placebo + CP. Median PFS was 22.6 months with bevacizumab + CP (95% confidence interval [CI]=18.6, not estimable) and 12.3 months (95% CI=9.5, 15.0) with placebo + CP (stratified hazard ratio=0.30; 95% CI=0.17, 0.53). Treatment-related grade 3/4 adverse events occurred in 46 of 49 (94%) patients receiving bevacizumab + CP, and 34 of 50 (68%) receiving placebo + CP. Conclusion Bevacizumab + CP showed clinically meaningful improvement in PFS vs placebo + CP, consistent with GOG-0218 results. Safety data were aligned with the known bevacizumab safety profile. These results support first-line bevacizumab + CP therapy in Chinese patients with ovarian cancer.

Objective: First-line bevacizumab plus carboplatin and paclitaxel (CP) is approved for stage III/IV ovarian cancer treatment following initial surgical resection, based on global phase III GOG-0218 and ICON7 trials. This study evaluated the efficacy and safety of bevacizumab + CP as first-line ovarian cancer therapy in Chinese patients. Methods: Patients with newly diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV epithelial ovarian, fallopian tube, or primary peritoneal cancer post-primary surgery were randomized 1:1 to receive 6 cycles of CP with bevacizumab/ placebo, followed by bevacizumab/placebo maintenance until unacceptable toxicity or disease progression. Primary endpoint was investigator-assessed progression-free survival (PFS). Stratification factors were FIGO stage and debulking status (stage III optimally debulked vs stage III suboptimally debulked vs stage IV) and Eastern Cooperative Oncology Group performance status (0 vs 1 or 2). Results: Of randomized patients, 51 received bevacizumab + CP and 49 received placebo + CP. Median PFS was 22.6 months with bevacizumab + CP (95% confidence interval [CI]=18.6, not estimable) and 12.3 months (95% CI=9.5, 15.0) with placebo + CP (stratified hazard ratio=0.30; 95% CI=0.17, 0.53). Treatment-related grade 3/4 adverse events occurred in 46 of 49 (94%) patients receiving bevacizumab + CP, and 34 of 50 (68%) receiving placebo + CP. Conclusion Bevacizumab + CP showed clinically meaningful improvement in PFS vs placebo + CP, consistent with GOG-0218 results. Safety data were aligned with the known bevacizumab safety profile. These results support first-line bevacizumab + CP therapy in Chinese patients with ovarian cancer.

Objective: First-line bevacizumab plus carboplatin and paclitaxel (CP) is approved for stage III/IV ovarian cancer treatment following initial surgical resection, based on global phase III GOG-0218 and ICON7 trials. This study evaluated the efficacy and safety of bevacizumab + CP as first-line ovarian cancer therapy in Chinese patients. Methods: Patients with newly diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV epithelial ovarian, fallopian tube, or primary peritoneal cancer post-primary surgery were randomized 1:1 to receive 6 cycles of CP with bevacizumab/ placebo, followed by bevacizumab/placebo maintenance until unacceptable toxicity or disease progression. Primary endpoint was investigator-assessed progression-free survival (PFS). Stratification factors were FIGO stage and debulking status (stage III optimally debulked vs stage III suboptimally debulked vs stage IV) and Eastern Cooperative Oncology Group performance status (0 vs 1 or 2). Results: Of randomized patients, 51 received bevacizumab + CP and 49 received placebo + CP. Median PFS was 22.6 months with bevacizumab + CP (95% confidence interval [CI]=18.6, not estimable) and 12.3 months (95% CI=9.5, 15.0) with placebo + CP (stratified hazard ratio=0.30; 95% CI=0.17, 0.53). Treatment-related grade 3/4 adverse events occurred in 46 of 49 (94%) patients receiving bevacizumab + CP, and 34 of 50 (68%) receiving placebo + CP. Conclusion Bevacizumab + CP showed clinically meaningful improvement in PFS vs placebo + CP, consistent with GOG-0218 results. Safety data were aligned with the known bevacizumab safety profile. These results support first-line bevacizumab + CP therapy in Chinese patients with ovarian cancer.

Objective:To investigate the effects of platelet-rich plasma injection therapy combined with muscle strength training on ankle function in patients with traumatic ankle arthritis.Methods:The clinical data of 98 patients with traumatic ankle arthritis admitted to The 906 Hospital of PLA Joint Logistics Support Force from January 2020 to January 2021 were retrospectively analyzed. These patients were grouped according to different treatment methods. Patients in the control group ( n = 31) received muscle strength training. Patients in the sodium hyaluronate group ( n = 33) received muscle strength training and intraarticular injection of sodium hyaluronate. Patients in the platelet-rich plasma group ( n = 34) received muscle strength training and intraarticular injection of platelet-rich plasma. Ankle function, excellent and good recovery rate, and muscle strength were compared among the three groups before and after treatment. Results:After treatment, the American Orthopaedic Foot & Ankle Society scores in the control, sodium hyaluronate, and platelet-rich plasma groups were (38.22 ± 3.02) points, (41.55 ± 2.04) points, and (44.22 ± 2.69) points respectively, pain scores were (26.98 ± 4.05) points, (31.22 ± 4.20) points, and (34.44 ± 2.44) points respectively, on-line scores were (6.11 ± 1.41) points, (7.39 ± 1.06) points, and (8.25 ± 1.03) points respectively. There were significant differences in the American Orthopaedic Foot & Ankle Society scores, pain scores, and online scores among the three groups ( F = 43.01, 34.30, 27.21, all P < 0.001). In the control, sodium hyaluronate, and platelet-rich plasma groups, dorsiflexor strength was (103.66 ± 10.69) N·m, (129.33 ± 12.37) N·m, (133.69 ± 10.58) N·m, respectively, plantar flexor strength was (121.36 ± 15.69) N·m, (140.23 ± 14.66) N·m, (144.55±13.55) N·m, respectively, ankle function score was (84.22 ± 2.69) points, (88.55 ± 3.01) points, (92.56 ± 3.55) points, respectively. There were significant differences in dorsiflexor strength, plantar flexor strength, and ankle function score among the three groups ( F = 66.37, 22.70, 58.05, all P < 0.001). There was no difference in adverse reactions among the three groups ( Z = 1.05, P > 0.05). Conclusion:Platelet-rich plasma injection therapy combined with muscle strength training is highly effective on traumatic ankle arthritis and can markedly improve ankle function and prognosis.

Objective:To investigate the relationship between Helicobacter pylori(Hp)infections in Parkinson's disease(PD)patients at high altitude and peripheral inflammatory markers.Methods:In this prospective study, 120 PD patients in Qinghai Province(altitude: 2260 m)were enrolled and evaluated using PD motor symptom scales and a non-motor symptom scale.The 13C-Urea breath test was used to detect Hp, and patients were divided into an Hp infection group and a non-Hp infection group based on test results.The levels of high-sensitivity C-reactive protein(hs-CRP), white blood cell counts and ratios, serum interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α)were measured. Results:The incidence of Hp infections in PD patients was 56.67%(68/120).The scores of Unified Parkinson's Disease Rating Scale(UPDRS)-Ⅲ, UPDRS-Ⅳ, total UPDRS, Hoehn-Yahr(H-Y)score, constipation scoring system(CSS)and Leeds dyspepsia questionnaire(LDQ)in the Hp infection group were higher than those in the non-Hp infection group, while the mini-mental state examination(MMSE)score was lower in the non-Hp infection group(all P<0.05).The neutrophil count, neutrophil-to-lymphocyte ratio(NLR), monocyte-to-lymphocyte ratio(MLR), serum IL-6 and TNF-α in the Hp-infection group were elevated compared with the non-Hp infection group(all P<0.05).Multivariate Logistic regression analysis showed that IL-6, TNF-α, NLR and H-Y score were independent risk factors for Hp infections in PD patients( OR=1.103, 1.188, 3.320, 4.593, respectively, all P<0.05).Correlation analysis showed that IL-6, TNF-α and NLR had positive correlations with UPDRS-Ⅲ( r=0.676, 0.644, 0.488, respectively), UPDRS-Ⅳ( r=0.679, 0.660, 0.430, respectively), UPDRS-total score( r=0.391, 0.448, 0.319, respectively), H-Y( r=0.610, 0.750, 0.460, respectively), CSS( r=0.529, 0.366, 0.212, respectively)and LDQ( r=0.581, 0.440, 0.263, respectively), but were negatively correlated with MMSE score( r=-0.617, -0.596, -0.321, respectively)(all P<0.05). Conclusions:Peripheral inflammation caused by Hp infections may be involved in the occurrence and development of Parkinson's disease at high altitude and serum IL-6, TNF-α and NLR could serve as indicators to evaluate PD patients with Hp infections.