Objective: To investigate the environmental contamination of norovirus in nurseries and primary/secondary schools, so as to provide a scientific basis for effective prevention and control measures. Methods: A total of 483 external environmental samples were collected from 34 cluster outbreaks of norovirus gastroenteritis in kindergartens and primary/secondary schools in Linhai City from 2021 to 2024. Pathogen detection was conducted using a rapid nucleic acid extraction kit and realtime fluorescence RT-PCR, and the results were analyzed using the χ2 test or Fishers exact test. Results: Among the collected external environmental samples, the total positive rate of surface contamination was 13.66%. The positive rates in kindergartens and primary/secondary schools were 12.20% and 15.82%, respectively. In kindergartens, the five surfaces with the highest detection rates were desks/chairs (23.33%), toilet stool troughs (20.69%), urinal troughs (12.00%), washbasins/sinks (11.11%), and toilet mops (9.38%). In primary/secondary schools, the top five were toilet stool troughs (38.30%), urinal troughs (23.53%), toilet door handles (13.04%), toilet mops (12.50%), and drinking cups (11.11%). The difference in positive detection rates among different external environments in primary/secondary schools was statistically significant (Fishers exact probability test, P<0.01). The positive detection rate in sanitary toilets was higher than that in classroom environments (χ2=17.38), while the positive detection rate in classroom environments of kindergartens was higher than that in primary/secondary schools (χ2=5.42)(P<0.05). Conclusions Norovirus exhibits a high contamination rate in nurseries and schools, particularly in restroom areas. Strengthening sanitation and disinfection in highrisk environments, and improving hygiene awareness among children and staff, are essential for the effective prevent and control of norovirus.

Objective We aimed to compare the efficacy and prognosis of percutaneous coronary intervention(PCI)in complex and high-risk patients with coronary heart disease(CHD)treated with extracorporeal membrane oxygenation(ECMO)combined with intra-aortic balloon pump(IABP)assistance,and explore the application value of combined use of mechanical circulatory support(MCS)devices in complex PCI.Methods A total of patients who met the inclusion criteria and underwent selective PCI supported by MCS at the Department of Cardiology,the First Affiliated Hospital of the Air Force Medical University from January 2018 to December 2022 were continuously enrolled.According to the mechanical circulatory support method,the patients were divided into ECMO+IABP group and IABP group.Clinical characteristics,angiographic features,in-hospital outcomes,and complications were collected.The intra-hospital outcomes and major adverse cardiovascular events(MACE)at one month and one year after the procedure were observed.The differences and independent risk factors between the two groups in the above indicators were analyzed.Results A total of 218 patients undergoing elective PCI were included,of which 66 patients were in the ECMO+IABP group and 152 patients were in the IABP group.The baseline characteristics of the two groups of patients were generally comparable,but the ECMO+IABP group had more complex lesion characteristics.The proportion of patients with atrial fibrillation(6.1％vs.0.7％,P=0.030),left main disease(43.9％vs.27.0％,P=0.018),triple vessel disease(90.9％vs.75.5％,P=0.009),and RCA chronic total occlusion disease(60.6％vs.35.5％,P＜0.001)was higher in the ECMO+IABP group compared to the IABP group.The proportion of patients with previous PCI history was higher in the IABP group(32.9％vs.16.7％,P=0.014).There was no statistically significant difference in the incidence of in-hospital complications between the two groups(P=0.176),but the incidence of hypotension after PCI was higher in the ECMO+IABP group(19.7％vs.9.2％,P=0.031).The rates of 1-month MACE(4.5％vs.2.6％,P=0.435)and 1-year MACE(7.6％vs.7.9％,P=0.936)were comparable between the two groups.Multivariate analysis showed that in-hospital cardiac arrest(OR 7.17,95％CI 1.27-40.38,P=0.025)and after procedure hypotension(OR 3.60,95％CI 1.10-11.83,P=0.035)were independent risk factors for the occurrence of 1-year MACE.Conclusions Combination use of ECMO+IABP support can provide complex and high-risk coronary heart disease patients with an opportunity to achieve coronary artery revascularization through PCI,and achieve satisfactory long-term prognosis.

The effect of porcine SIRT5 on replication of foot and mouth disease virus type O(FMDV-O)and the underlying regulatory mechanism were investigated.Western blot and RT-qPCR analyses were employed to monitor expression of endoge-nous SIRT5 in PK-15 cells infected with FMDV-O.Three pairs of SIRT5-specific siRNAs were synthesized.Changes to SIRT5 and FMDV-O protein and transcript levels,in addition to virus copy numbers,were measured by western blot and RT-qPCR analyses.PK-15 cells were transfected with a eukaryotic SIRT5 expression plasmid.Western blot and RT-qPCR analyses were used to explore the impact of SIRT5 overexpression on FMDV-O replication.Meanwhile,RT-qPCR analysis was used to detect the effect of SIRT5 overexpression on the mRNA expression levels of type I interferon-stimulated genes induced by SeV and FMDV-O.The results showed that expression of SIRT5 was up-regulated in PK-15 cells infected with FMDV-O and siRNA interfered with SIRT5 to inhibit FMDV-O replication.SIRT5 overexpression promoted FMDV-O replication.SIRT5 over-expression decreased mRNA expression levels of interferon-stimulated genes induced by SeV and FMDV-O.These results suggest that FMDV-O infection stimulated expression of SIRT5 in PK-15 cells,while SIRT5 promoted FMDV-O rep-lication by inhibiting production of type I interferon-stimula-ted genes.These findings provide a reference to further ex-plore the mechanism underlying the ability of porcine SIRT5 to promote FMDV-O replication.

Objective To apply a COMSOL-based finite element analysis method to investigating the electric field effects produced by the human lower limb musculoskeletal system under the synergistic effects of stress field and electromagnetic field.Methods Firstly,a 3D human body model was constructed by Maxon Cinema 4D R21 software,and then imported into COMSOL 6.1 software in STL format.Secondly,an electromagnetic field intervention and stress loading model for the left lower limb of the human body was designed and constructed,in which 15 Hz quasi-pulse group current signals were used for electromagnetic field excitation and the stress field was realized by applying a vibration load with an average compressive force of about 90 N/cm2 to the left foot of the human body.Finally,the electromagnetic properties of human tissue were simulated by numerical simulation,and then the effects of stress field or elecromagnetic field or combined stress field and electromagnetic field on human bioelectric field were compared.Results Simulation results showed that the electric field intensity peaked at the leg joints under both electromagnetic and stress fields acting alone or synergistically,the bioelectric field intensity generated by the human body was related to the distance from the exogenous excitation loading location,and the electric field generated under synergistic action was equivalent to the linear superposition of the bioelectric field in the tissue induced by the electromagnetic field and the stress field acting alone.Conclusion Data supplement is provided for predicting bioelectric field changes within the musculoskeletal tissue,and theoretical foundation is laid for the development and application of multi-physics field synergistic intervention therapy for treating the disorders of the lower limb musculos-keletal system.[Chinese Medical Equipment Journal,2024,45(9):21-26]

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Consultation fees are included in the service homogenization,standardization,patient awareness,relatively high frequency of clinical use,and the general project catalog commonly carried out by public hospitals.On the basis of sorting out the elements of consultation fee price items in some provinces,this paper summarizes the setting of trigger conditions and rules for dynamic adjustment of consultation fee prices in typical regions,and the progress of substantive start-up of dynamic adjustment for consultation fee prices.It compares the level of consultation fees in some provinces,and analyzes the problems faced by consultation fee fees.Some provinces have not dynamically adjusted the examination fee for a long time,and the price comparison relationship with neighboring regions is not coordinated.The policy direction and operational suggestions for improving the dynamic adjustment mechanism of consultation fee price include:Integrating the elements of consultation price items and improving the price standardization level;Popularize the experience of typical areas,after evaluation,start the dynamic price adjustment of consultation items.

Consultation fees are included in the service homogenization,standardization,patient awareness,relatively high frequency of clinical use,and the general project catalog commonly carried out by public hospitals.On the basis of sorting out the elements of consultation fee price items in some provinces,this paper summarizes the setting of trigger conditions and rules for dynamic adjustment of consultation fee prices in typical regions,and the progress of substantive start-up of dynamic adjustment for consultation fee prices.It compares the level of consultation fees in some provinces,and analyzes the problems faced by consultation fee fees.Some provinces have not dynamically adjusted the examination fee for a long time,and the price comparison relationship with neighboring regions is not coordinated.The policy direction and operational suggestions for improving the dynamic adjustment mechanism of consultation fee price include:Integrating the elements of consultation price items and improving the price standardization level;Popularize the experience of typical areas,after evaluation,start the dynamic price adjustment of consultation items.

Consultation fees are included in the service homogenization,standardization,patient awareness,relatively high frequency of clinical use,and the general project catalog commonly carried out by public hospitals.On the basis of sorting out the elements of consultation fee price items in some provinces,this paper summarizes the setting of trigger conditions and rules for dynamic adjustment of consultation fee prices in typical regions,and the progress of substantive start-up of dynamic adjustment for consultation fee prices.It compares the level of consultation fees in some provinces,and analyzes the problems faced by consultation fee fees.Some provinces have not dynamically adjusted the examination fee for a long time,and the price comparison relationship with neighboring regions is not coordinated.The policy direction and operational suggestions for improving the dynamic adjustment mechanism of consultation fee price include:Integrating the elements of consultation price items and improving the price standardization level;Popularize the experience of typical areas,after evaluation,start the dynamic price adjustment of consultation items.

Consultation fees are included in the service homogenization,standardization,patient awareness,relatively high frequency of clinical use,and the general project catalog commonly carried out by public hospitals.On the basis of sorting out the elements of consultation fee price items in some provinces,this paper summarizes the setting of trigger conditions and rules for dynamic adjustment of consultation fee prices in typical regions,and the progress of substantive start-up of dynamic adjustment for consultation fee prices.It compares the level of consultation fees in some provinces,and analyzes the problems faced by consultation fee fees.Some provinces have not dynamically adjusted the examination fee for a long time,and the price comparison relationship with neighboring regions is not coordinated.The policy direction and operational suggestions for improving the dynamic adjustment mechanism of consultation fee price include:Integrating the elements of consultation price items and improving the price standardization level;Popularize the experience of typical areas,after evaluation,start the dynamic price adjustment of consultation items.

Consultation fees are included in the service homogenization,standardization,patient awareness,relatively high frequency of clinical use,and the general project catalog commonly carried out by public hospitals.On the basis of sorting out the elements of consultation fee price items in some provinces,this paper summarizes the setting of trigger conditions and rules for dynamic adjustment of consultation fee prices in typical regions,and the progress of substantive start-up of dynamic adjustment for consultation fee prices.It compares the level of consultation fees in some provinces,and analyzes the problems faced by consultation fee fees.Some provinces have not dynamically adjusted the examination fee for a long time,and the price comparison relationship with neighboring regions is not coordinated.The policy direction and operational suggestions for improving the dynamic adjustment mechanism of consultation fee price include:Integrating the elements of consultation price items and improving the price standardization level;Popularize the experience of typical areas,after evaluation,start the dynamic price adjustment of consultation items.