OBJECTIVE To explore the implementation and standardized management of infection control core ele-ments in grass-roots medical institutions within county-level medical communities.METHODS From Mar.2024 to Apr.2024,the current status of implementation of infection control core elements in the grass-roots medical institu-tions within county-level medical communities was investigated by means of questionnaire survey and qualita-tive interview,and the implementation strategies were further explored.RESULTS The infection management or-ganizational system and functions of the two county-level medical institutions within the county medical communi-ties were completed,there is no independent hospital infection management department in the primary medical in-stitutions.The infection management personnel in the 16 grass-roots medical institutions were part-time person-nel,the personnel with the educational background below junior college accounted for 84.21％,the personnel with the professional background of nursing accounted for 100.00％,the personnel with less than 5 years of working experience accounted for 78.95％,none of them had an on-the-job training certificate.The monitoring programs of the county-level medical institutions within the county medical communities were completed,there was no infec-tion management monitoring information platform in the grass-roots medical institutions.The infection cases,hand hygiene,environmental health and occupational exposures were monitored by people.The grass-roots medi-cal institutions had the highest requirements for various professional trainings and increase of training contents of prevention and control of public health infectious diseases(100.00％).The county-level medical institutions had inadequate capabilities of professional examination of medical equipment replacement and construction of medi-cal architecture.CONCLUSION It is necessary for the country and local levels of governments to attach great importance to the implementation of the infection control core elements in the grass-roots medical institutions within the county-lev-el medical communities,establish the county-level regional information platform,formulate the corresponding surveil-lance indexes and homogenized management systems,complete the cultivation of talents,and offer financial support.

Hedysari radix is the characteristic chi-nese medicine of Gansu Province,with"MiCang Hedysari radix"as the best.Modern pharmacologi-cal research has shown that it has polysaccharides and flavonoids,which have good anti-tumor effects and can inhibit the occurrence and development of various cancers,such as lung cancer,liver cancer,and breast cancer.Cancer is ranked as the second leading cause of death in the world,and the mor-bidity and mortality rates are increasing year by year,seriously affecting the quality of life.At pres-ent,with the modernization of Traditional Chinese Medicine(TCM),there has been a significant break-through in the treatment of malignant tumors with TCM.Based on this,by collating the relevant litera-ture at home and abroad in recent years,the anti-tumor effects and mechanisms of Hedysari radix and its active ingredients are summarized to pro-vide a scientific basis for the study of elucidating the material basis of the anti-tumor effects of He-dysari radix and to promote the development of the Hedysari radix industry.

Hedysari radix is the characteristic chi-nese medicine of Gansu Province,with"MiCang Hedysari radix"as the best.Modern pharmacologi-cal research has shown that it has polysaccharides and flavonoids,which have good anti-tumor effects and can inhibit the occurrence and development of various cancers,such as lung cancer,liver cancer,and breast cancer.Cancer is ranked as the second leading cause of death in the world,and the mor-bidity and mortality rates are increasing year by year,seriously affecting the quality of life.At pres-ent,with the modernization of Traditional Chinese Medicine(TCM),there has been a significant break-through in the treatment of malignant tumors with TCM.Based on this,by collating the relevant litera-ture at home and abroad in recent years,the anti-tumor effects and mechanisms of Hedysari radix and its active ingredients are summarized to pro-vide a scientific basis for the study of elucidating the material basis of the anti-tumor effects of He-dysari radix and to promote the development of the Hedysari radix industry.

OBJECTIVE To explore the implementation and standardized management of infection control core ele-ments in grass-roots medical institutions within county-level medical communities.METHODS From Mar.2024 to Apr.2024,the current status of implementation of infection control core elements in the grass-roots medical institu-tions within county-level medical communities was investigated by means of questionnaire survey and qualita-tive interview,and the implementation strategies were further explored.RESULTS The infection management or-ganizational system and functions of the two county-level medical institutions within the county medical communi-ties were completed,there is no independent hospital infection management department in the primary medical in-stitutions.The infection management personnel in the 16 grass-roots medical institutions were part-time person-nel,the personnel with the educational background below junior college accounted for 84.21％,the personnel with the professional background of nursing accounted for 100.00％,the personnel with less than 5 years of working experience accounted for 78.95％,none of them had an on-the-job training certificate.The monitoring programs of the county-level medical institutions within the county medical communities were completed,there was no infec-tion management monitoring information platform in the grass-roots medical institutions.The infection cases,hand hygiene,environmental health and occupational exposures were monitored by people.The grass-roots medi-cal institutions had the highest requirements for various professional trainings and increase of training contents of prevention and control of public health infectious diseases(100.00％).The county-level medical institutions had inadequate capabilities of professional examination of medical equipment replacement and construction of medi-cal architecture.CONCLUSION It is necessary for the country and local levels of governments to attach great importance to the implementation of the infection control core elements in the grass-roots medical institutions within the county-lev-el medical communities,establish the county-level regional information platform,formulate the corresponding surveil-lance indexes and homogenized management systems,complete the cultivation of talents,and offer financial support.

Objective:To explore the application value of histogram and texture feature analysis based on CT images in distinguishing long bone osteosarcoma (OS) from Ewing sarcoma (ES).Methods:A retrospective collection of 25 patients with long bone osteosarcoma and 25 patients with Ewing sarcoma confirmed by surgery and pathology in National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Qilu Hospital of Shandong University and Nanjing Drum Tower Hospital, Nanjing University Medical School, from March 2018 to May 2023 was conducted. All patients were randomly divided into a training set (21 cases of OS and 19 cases of ES) and a validation set (4 cases of OS and 6 cases of ES) in an 8∶2 ratio. The region of interest (ROI) on CT images to extract texture feature parameters was manually sketched. Random forest and least absolute shrinkage and selection operator (LASSO) algorithm were used for feature screening. Logistic regression (LR), random forest (RF), support vector machine (SVM) and K-nearest neighbor (KNN) classifiers were used to establish models respectively. Receiver operating characteristic (ROC)curve was drawn and area under the curve (AUC) was calculated to evaluate the diagnostic efficiency of the four models.Results:A total of 100 texture parameters were extracted from CT images, and 8 feature parameters (maximum 3D diameter, 10th percentile, kurtosis, maximum pixel intensity value, inverse normalization, grayscale level variance, long range high grayscale emphasis, and low grayscale area emphasis) were obtained through screening. Four classifiers were used to establish models, and the AUC values of the four models (LR, RF, SVM, KNN) in the validation group were 0.92, 0.79, 0.83, and 0.73, respectively. LR and SVM classifier algorithm trains models had high diagnostic efficiency, with an accuracy of 90%, sensitivity of 83%, specificity of 100%, and AUC of 92% for the LR classifier validation set; the accuracy of SVM classifier validation set was 80%, sensitivity was 67%, specificity was 100%, and AUC was 83%.Conclusions:LR and SVM models have high value in distinguishing OS and ES.

Fulminant myocarditis occurs suddenly and progresses rapidly, often leading to severe heart failure, hypotension, or cardiogenic shock. Widespread myocardial calcification secondary to fulminant myocarditis is clinically rare, with sporadic reports both domestically and internationally. This article reports a case of a young female patient who presented with acute onset and rapidly deteriorating condition, with imaging indicating myocardial calcification by the second day of hospitalization, highlighting the unusual speed of progression.

Objective To assess early clinical safety and efficacy of transfemoral transcatheter aortic valve replacement (TF-TAVR) for pure aortic regurgitation (PAR). Methods The clinical data of PAR patients who underwent TAVR in Wuhan Asia Heart Hospital and Wuhan Asia General Hospital from January 2018 to October 2022 were retrospectively analyzed. Patients were divided into a TF-TAVR group and a transapical transcatheter aortic valve replacement (TA-TAVR) group. The clinical data of the patients were analyzed. Results A total of 54 patients were enrolled, including 34 males and 20 females with an average age of 74.43±6.87 years. The preoperative N-terminal pro-B-type natriuretic peptide level was lower [808.50 (143.50, 2 937.00) pg/mL vs. 2 245.00 (486.30, 7 177.50) pg/mL, P=0.015], and the left ventricular end-diastolic diameter (56.00±6.92 mm vs. 63.07±10.23 mm, P=0.005) and sinus junction diameter (32.47±4.41 mm vs. 37.65±8.08 mm, P=0.007) were smaller in the TF-TAVR group. There was no death in the two groups during the hospitalization. Only 1 new death within postoperative 1 month in the TF-TAVR group (cerebral hemorrhage). A total of 2 new deaths in the TF-TAVR group (1 patient of sudden cardiac death and 1 of multiple organ failure), and there was no death in the TA-TAVR group within postoperative 3 months. There was 1 new death in the TA-TAVR group (details unknown), and there was no death in the TF-TAVR group within postoperative 6 months. There was no statistical difference between the two groups in the all-cause mortality and the cumulative survival rate during the follow-up period (P>0.05). The incidence of high atrioventricular block was 36.0% in the TF-TAVR group and 10.3% in the TA-TAVR group (P=0.024). There were no significant differences between the two groups in the perivalvular leakage (≥moderate), valve in valve, a second valve implantation, valve migration, cerebrovascular events, major vascular complications, complete left bundle branch block, new permanent pacemaker implantation or transferring to surgery (P>0.05). However, the incidence rates of complete left bundle branch block and new permanent pacemaker implantation were higher in the TF-TAVR group, accounting for 56.0% and 40.0%, respectively. Conclusion TF-TAVR is a safe and feasible treatment for PAR patients, which is comparable to TA-TAVR in the early postoperative safety and efficacy.

Objective To predict the core targets and action pathways of Hedysari Radix based on UPLC-MS/MS and network pharmacology methods,and to verify the results of network pharmacology by molecular docking and molecular dynamics techniques.This article aims to investigate immune regulation mechanism of effective components absorbed into blood from Hedysari Radix.Methods Qualitative quantification of effective components absorbed into blood from Hedysari Radix were operated by using UPLC-MS/MS technique.The corresponding targets of effective components absorbed into blood from Hedysari Radix were screened by TCMSP and HERB databases.Targets of immune-related disease were obtained through DisGeNET,OMIM,TTD,and MalaCards databases.The network of"components absorbed into blood from Hedysari Radix-immune-related diseases"was then constructed.GO and KEGG enrichment analysis and mapped the PPI network were performed.Molecular docking and molecular dynamics techniques were applied for validation.Results A total of 8 prototype components absorbed into blood,synergistically acting on 101 targets,were identified by UPLC-MS/MS.They mediated 538 biological processes including immune response,positive regulation of gene expression,receptor binding,and cytokine activity.Meanuhile,116 signaling pathways,such as HIF-1,Toll-like receptor,JAK-STAT,T cell receptor,PI3K-Akt,and FoxO etc.were involved.The core targets were MAPK14,PTGS2,MMP9,PPARG,CCND1,etc..The results of molecular docking showed that formononetin and calycosin had strong docking binding activity with MAPK14.And molecular dynamics simulations further demonstrated that the binding between MAPK14 and formononetin or calycosin had good structural stability and binding affinity.Conclusion The results of serum pharmacochemistry,network pharmacology and molecular dynamics were verified to reveal the material basis and mechanism of Hedysari Radix in regulating immunity.The aim of this study is to provide scientific basis for its immunomodulatory mechanism.

OBJECTIVE: To compared the effect of different drying methods on drying characteristics, water effective diffusion coefficient and biased activation energy of Codonopsis Radix and to definite 3 different drying methods of varying temperature(45-55-60, 60-55-45, 60-45-60℃) and 3 constant temperature(45, 55, 60℃) on drying characteristic curves of different commercial grades of Codonopsis Radix. METHODS: Used R2, χ2 and RMSE as evaluation indexes, 10 typical drying kinetic models were selected to fit the drying curve of Codonopsis Radix, and the effective moisture diffusion coefficient and biased activation energy under different drying method were calculated. RESULTS: It was found that the Midilli model could well describe the drying process of different commercial grades of Codonopsis Radix, the water ratio of Codonopsis Radix showed an exponential downward trend. If the initial drying temperature was set above 55℃, the maximum drying rate could be reached within 2 h. And commercial grades temperature had certain influence on the effective water diffusion coefficient of Codonopsis Radix. Under the same temperature condition, the average speed of moisture migration during drying of Codonopsis Radix was:first-class> second-class>third-class, and the Deffwere 10.433 9×10-8, 5.545 2×10-8, 2.249 6×10-8·m2·s, respectively. The calculated bias activation energy of Codonopsis Radix was 2.943×104-4.378×104 J·mol-1, the order of bias activation energy of different drying methods was as follows:60-55-45℃ variable temperature<60-45-60℃ variable temperature<45-55-60℃ variable temperature<55℃ constant temperature<60℃ constant temperature <45℃ constant temperature, which indicated that the moisture in the medicinal materials was more likely to evaporate and overflow and consumes less energy than the constant temperature drying. In particular, the bias activation energy of 60-55-45℃ drying method was 77.54% and 81.86% of the other 2 variable temperature drying methods, which were 67.22%, 75.13% and 74.26% of the 3 kinds of constant temperature drying. CONCLUSION The use of cooling mode in the drying process can save more time and energy, and can provide experimental basis for the improvement of drying technology and optimization of drying process of Codonopsis Radix.

Objective:To investigate the current management of nosocomial infection at medical institutions of all levels in Changzhou, so as to provide basis for standardizing nosocomial infections control of hospitals within a medical alliance.Methods:An electronic questionnaire was customized for online survey of 91 hospitals affiliated to eight regional medical alliances in Changzhou city in March 2019. The survey covered such aspects as general conditions of the hospital, profile of nosocomial infection control administrators and other staffing, supervision of hospital nosocomial infection programs, and training needs, as well as outstanding problems and suggestions.Frequency number and percentage represent enumeration data, and χ2 test was used to analyze the in-group differences of medical institutions of three levels. Results:Tertiary public hospitals were superior to the secondary and primary hospitals in organizational structure, professional staffing and target monitoring, with the differences of statistical significance( P<0.05). The most urgent training needs of medical institutions at all levels were knowledge in determination and reporting of infectious diseases/nosocomial infection/infection outbreaks; top imperatives and recommendations were development of operation rules for primary medical institutions and standardization of workflows. Conclusions:Staff of primary medical institutions need capacity building in nosocomial infection control; primary hospitals are equipped with incomplete nosocomial infection control information platform; key departments in general lack homogenous management. Tertiary hospitals are encouraged to play leadership in medical alliances in achieving standardized, homogenous and informationized nosocomial infection control within the medical alliances.