Objective To investigate the influencing factors of antibiotic-associated diarrhea(AAD)following congenital heart disease(CHD)surgery in pediatric patients,develop a nomogram-based predictive model,and validate its efficacy.Methods A retrospective analysis was conducted on the clinical data of pediatric patients who underwent CHD surgery in the Pediatric Intensive Care Unit(PICU)of a tertiary hospital in Guang-dong Province from July 2022 to July 2024.Patients were categorized into an AAD group and a non-AAD group.Univariate and multivariate logistic regression analyses were performed to identify risk factors for AAD occurrence following CHD surgery.A risk prediction model was developed,and a nomogram was constructed.The predictive performance of the model was evaluated using the Receiver Operating Characteristic(ROC)curve to calculate the area under the curve(AUC),the Hosmer-Lemeshow goodness-of-fit test,calibration curves,and clinical decision curve analysis.External validation of the model was conducted using data from patients in the Surgical Intensive Care Unit(SICU).Results The incidence of AAD following CHD surgery was 48.52%(229 out of 472 cases).Risk factors for AAD included the combined use of antibiotics,mechanical ventilation,elevated C-reactive protein levels,prolonged surgical duration,and extended antibiotic usage time(all with OR>1,P<0.05).Conversely,probiotic administration was identified as a protective factor(OR<1,P<0.05).The predictive model demon-strated excellent discrimination,as evidenced by the ROC curve areas:0.922(95%CI:0.894～0.951)in the modeling group,0.886(95%CI:0.838～0.915)in the internal validation group,and 0.862(95%CI:0.784～0.941)in the external validation group.Additionally,the model exhibited satisfactory calibration,as indicated by the Hosmer-Lemeshow test results:χ2=7.96,P=0.538 in the modeling group;χ2=4.24,P=0.895 in the inter-nal validation group;and χ2=9.923,P=0.270 in the external validation group.Furthermore,the model provided significant clinical utility.Conclusions Combined antibiotic use,duration of antibiotic therapy,mechanical ventilation,surgical duration,C-reactive protein(CRP)levels,and probiotic administration are key factors influ-encing the occurrence of AAD.The risk prediction model developed based on these variables demonstrates robust predictive performance and can serve as a valuable reference for the development and implementation of preventive and therapeutic strategies in clinical practice.

Objective:To understand the current status of scientific and technological personnel cognition regarding patent transformation and utilization in hospitals, explore the implementation effectiveness and existing problems of hospital patent operation management measures, and thereby identify key areas and provide targeted guidance for subsequent improvement efforts.Methods:A questionnaire survey was conducted among scientific and technological personnel at a tertiary public hospital in Shanghai. The survey assessed their patent knowledge, investigated their training needs related to patent transformation and utilization, and evaluated the perceived importance and satisfaction with the hospital′s patent operation management measures. Descriptive statistics, ANOVA, t-tests, and Importance-Performance Analysis (IPA) were used to analyze the personnel's improvement demands regarding patent operation.Results:A total of 261 scientific and technological personnel were included. Their overall patent knowledge assessment score was relatively low (46.86±15.52), and their training topic needs were dispersed. The mean scores for both importance (4.13±0.74) and satisfaction (3.90±0.80) regarding the 11 hospital patent operation management measures were above the midpoint. IPA results indicated that: four measures, including ″improving patent transformation/utilization regulations″ and ″implementing salary rewards for achievements transformation, ″ should be maintained (high importance, high satisfaction); two measures, including ″establishing special funds for achievements transformation″ and ″introducing professional service agencies″, require concentrated improvement (high importance, low satisfaction); three measures, including ″building medical-industry-academia-research collaboration platforms″ and ″implementing tiered and classified training″, could be opportunistically optimized (low importance, high satisfaction); two measures, including ″integrating achievements transformation into hospital priorities″ and ″linking patent transformation to performance evaluation and professional promotion″, showed no priority for improvement (low importance, low satisfaction).Conclusions:Effective hospital patent operation management necessitates establishing a robust organizational and institutional framework, cultivating scientific talent with a transformation-oriented mindset, optimizing resource inputs such as funding, technology, information, and services, and actively exploring new paradigms for medical-industry-academia-research collaboration.

Objective To investigate the influencing factors of antibiotic-associated diarrhea(AAD)following congenital heart disease(CHD)surgery in pediatric patients,develop a nomogram-based predictive model,and validate its efficacy.Methods A retrospective analysis was conducted on the clinical data of pediatric patients who underwent CHD surgery in the Pediatric Intensive Care Unit(PICU)of a tertiary hospital in Guang-dong Province from July 2022 to July 2024.Patients were categorized into an AAD group and a non-AAD group.Univariate and multivariate logistic regression analyses were performed to identify risk factors for AAD occurrence following CHD surgery.A risk prediction model was developed,and a nomogram was constructed.The predictive performance of the model was evaluated using the Receiver Operating Characteristic(ROC)curve to calculate the area under the curve(AUC),the Hosmer-Lemeshow goodness-of-fit test,calibration curves,and clinical decision curve analysis.External validation of the model was conducted using data from patients in the Surgical Intensive Care Unit(SICU).Results The incidence of AAD following CHD surgery was 48.52%(229 out of 472 cases).Risk factors for AAD included the combined use of antibiotics,mechanical ventilation,elevated C-reactive protein levels,prolonged surgical duration,and extended antibiotic usage time(all with OR>1,P<0.05).Conversely,probiotic administration was identified as a protective factor(OR<1,P<0.05).The predictive model demon-strated excellent discrimination,as evidenced by the ROC curve areas:0.922(95%CI:0.894～0.951)in the modeling group,0.886(95%CI:0.838～0.915)in the internal validation group,and 0.862(95%CI:0.784～0.941)in the external validation group.Additionally,the model exhibited satisfactory calibration,as indicated by the Hosmer-Lemeshow test results:χ2=7.96,P=0.538 in the modeling group;χ2=4.24,P=0.895 in the inter-nal validation group;and χ2=9.923,P=0.270 in the external validation group.Furthermore,the model provided significant clinical utility.Conclusions Combined antibiotic use,duration of antibiotic therapy,mechanical ventilation,surgical duration,C-reactive protein(CRP)levels,and probiotic administration are key factors influ-encing the occurrence of AAD.The risk prediction model developed based on these variables demonstrates robust predictive performance and can serve as a valuable reference for the development and implementation of preventive and therapeutic strategies in clinical practice.

Objective:To understand the current status of scientific and technological personnel cognition regarding patent transformation and utilization in hospitals, explore the implementation effectiveness and existing problems of hospital patent operation management measures, and thereby identify key areas and provide targeted guidance for subsequent improvement efforts.Methods:A questionnaire survey was conducted among scientific and technological personnel at a tertiary public hospital in Shanghai. The survey assessed their patent knowledge, investigated their training needs related to patent transformation and utilization, and evaluated the perceived importance and satisfaction with the hospital′s patent operation management measures. Descriptive statistics, ANOVA, t-tests, and Importance-Performance Analysis (IPA) were used to analyze the personnel's improvement demands regarding patent operation.Results:A total of 261 scientific and technological personnel were included. Their overall patent knowledge assessment score was relatively low (46.86±15.52), and their training topic needs were dispersed. The mean scores for both importance (4.13±0.74) and satisfaction (3.90±0.80) regarding the 11 hospital patent operation management measures were above the midpoint. IPA results indicated that: four measures, including ″improving patent transformation/utilization regulations″ and ″implementing salary rewards for achievements transformation, ″ should be maintained (high importance, high satisfaction); two measures, including ″establishing special funds for achievements transformation″ and ″introducing professional service agencies″, require concentrated improvement (high importance, low satisfaction); three measures, including ″building medical-industry-academia-research collaboration platforms″ and ″implementing tiered and classified training″, could be opportunistically optimized (low importance, high satisfaction); two measures, including ″integrating achievements transformation into hospital priorities″ and ″linking patent transformation to performance evaluation and professional promotion″, showed no priority for improvement (low importance, low satisfaction).Conclusions:Effective hospital patent operation management necessitates establishing a robust organizational and institutional framework, cultivating scientific talent with a transformation-oriented mindset, optimizing resource inputs such as funding, technology, information, and services, and actively exploring new paradigms for medical-industry-academia-research collaboration.

Objective? To define the difficulty coefficient of Operating Room nursing items which is suitable for difficulty evaluation and can represent the workload of Operating Room nursing. Methods? From January 2017 to March 2018, through literature review, questionnaire survey and expert demonstration meeting, the nursing work items and operational difficulty indicators suitable for difficulty evaluation in Operating Room were determined. The weight of difficulty indicators was determined by analytic hierarchy process. Fifteen experts were selected for three rounds of Delphi inquiry. The coefficients of difficulty were determined by weighted linear method. Results? Finally, the difficulty coefficients of 68 operating room nursing items were obtained. The top three difficulty coefficients were "position placement and observation of lateral traction bed (7.268 7)", "position placement and observation of fixed skull (7.254 0)" and "position and observation of skull-brain frame lateral decubitus position (7.243 3)"; the last three difficulty coefficients were "horizontal supine position placement and observation (2.178 2)" and "sterile sheet laying (2.046 0)" , "no-contact wearing of sterile gloves (1.000 0)". Conclusions? This study defines 68 difficulty coefficients of operating room nursing work items which are suitable for difficulty evaluation and can represent the workload of Operating Room nursing. It can quantify the difficulty of Operating Room nursing work items and enhance the rationality of Operating Room nursing workload counting.

Objective To understand the status of infection with multidrug-resistant organisms (MDROs) in intensive care units(ICUs),and evaluate the intervention efficacy of targeted monitoring.Methods Prospective study was adopted,patients who were admitted to ICUs in 2014-2015 were selected (January-December 2014 was as preintervention stage,January-December 2015 was as intervention stage),trend of MDRO infection before and after intervention were compared and analyzed.Results Before and after intervention,297 and 217 strains of MDROs were isolated respectively,except carbapenem-resistant Pseudomonasaeruginosa (CRPA),the isolated strains of carbapenem-resistant Acinetobacterbaunannii (CRAB),carbapenem-resistant Enterobacteriaceae (CRE),methicillin-resistant Staphylococcus aureus(MRSA),and vancomycin-resistant Enterococcus (VRE) declined after intervention.MDRO infection rate declined from 7.17 ％ before intervention to 3.88％ after intervention,infection rate of CRAB and CRE after intervention were both lower than before intervention (both P＜0.05);MDRO infection rates in general ICU and internal medicine ICU increased from 8.75％ and 7.84‰ before intervention to 4.39‰ and 2.28％ after intervention,respectively (both P＜0.05).After taking comprehensive intervention measures,compliance to prevention and control measures,such as ordering rate of doctor's advice on contact isolation for 24 hours,hand hygiene,health care workers' awareness all enhanced significantly(all P＜0.05).Conclusion Targeted monitoring and intervention measures can reduce isolation rate of MDROs in ICUs.

Objective To explore the CT and MRI manifestations and clinical features of juxtaglomerular cell tumor (JGCT). Methods A retrospective analysis the data of eight JGCT patients who resected by surgery and comfirmed by histopathology. Seven cases were examined by CT before operation, five of whom underwent CT scan and dynamic enhanced scan, two of whom underwent CT scan, and all of the eight underwent MRI scan and dynamic enhanced scan. The clinical manifestations of patients were also observed, whether they have hypertension and reduced blood potassium, recorded the results of lying and standing test, and collected the segmental renal vein blood to detect the renin levels. Meanwhile, the CT and MRI manifestations were also recorded. Results (1) We found that all of the eight patients appeared hypertension, and hypokalemia were found among five cases. Seven patients proceeded the lying and standing test, six of whom the plasma renin activity (PRA) were elevate in erect position, and the levels of angiotensin Ⅱand aldosterone (ALD) were rised among all of the seven cases in erect position. Four patients were collected the segmental renal vein blood, and one of whom has positive result of the renin activity. (2) The tumors of all the eight cases were single, the border was clear, and the average size was 2.7 cm (range 1.9 to 3.8 cm). The CT scan results showed there's no calcification or pseudocapsule were detected, four cases showed homogeneous iso-density, one case with slightly high density, another one showed low density with dotty high density and one case with low density. The dynamic enhanced CT scan showed that four cases performed continuous enhancement from cortical to medullary phase, and no obvious enhancement was found in one case. The T2WI results of MRI scan showed six cases had pseudocapsule, 6 cases had heterogeneous signal (4 cases with patchy low signal and 2 cases with patchy high signal), and 2 cases had homogeneous signal (one case with iso-high signal and another with high signal). The T1WI results showed two cases performed low signal, anther two cases showed iso-signal, and four cases with heterogeneous signal. The DWI results showed all of the 8 lesions with homo-or peripheral high signal. The dynamic enhanced MRI scan results showed seven cases performed gradual enhancement, and the border of another case became clear on delay phase. Conclusions JGCT has specific clinical and imaging features, and the combination will help make a correct diagnosis.

The aim of this study was to develop a formulation to improve the oral absorption of baicalin (BA) by combining a phospholipid complex (PC) and self-emulsifying microemulsion drug delivery system (SMEDDS), termed BA-PC-SMEDDS. BA-PC was prepared by a solvent evaporation method and evaluated by complexation percentage (CP). The physicochemical properties of BA-PC were determined. The synergistic effect of PC and SMEDDS on permeation of BA was studied in vitro with Caco-2 cells and in situ with a single pass intestinal perfusion model. The improved bioavailability of BA in BA-PC-SMEDDS was confirmed in an in vivo rat model. The CP of BA-PC reached 100% when the molar ratio of drug to phospholipid (PP) was ≥1:1. The solubility of BA-PC increased in both water and octanol, and the log P o/w of BA-PC was increased significantly. BA-PC-SMEDDS could be dispersed more evenly in water, compared to BA and BA-PC. Both the Caco-2 cell uptake and single-pass intestinal perfusion models illustrated that transport of BA in BA-PC was lower than that of free BA, while improved significantly in BA-PC-SMEDDS. The relative bioavailability of BA-PC(1:2)-SMEDDS was 220.37%. The combination system of PC and SMEDDS had a synergistic effect on improving the oral absorption of BA.

Objective To observe the clinical efficacy of herbs by internal and external administration combined with semiconductor laser irradiation in the treatment of chronic eczema.Methods Eighty-six patients with chronic eczema were divided into the herb group and the laser group by the randomized digital table,43 patients in each group.The patients in the herb group received oral administration with Chinese herbs together with application of herbs on the affected foci.The patients in the laser group received the same treatment as in the herb group and meanwhile treated with additional semiconductor laser therapy.The clinical effects were evaluated according to their itch degree and skin lesions.Result The cure rate and total effective rate were both significantly higher in the laser group than those in the herb group(P<0.05).Conclusion Compared with herbal internal and external administration only,the clinical efficacy of herbal internal and external administration combined with semiconductor laser irradiation is more effective in the treatment of chronic eczema.

Objective To assess the diagnostic value of MRI on multiple focal nodular hyperplasia (FNH) of the liver. Methods MR images of 9 cases with pathological-confirmed multiple FNH were retrospectively analyzed. MRI features of the lesions were correlated with pathological findings. Results Multiple FNH was considered in all these 9 cases. Among them, the primary diagnosis was FNH in 5,hepatic adenoma in 3 and fibrolamellar hepatocellular carcinoma in 1 case. A total of 31 lesions were detected in the 9 cases. On T2WI, 19 lesions presented slightly high-signal intensity, and the other 12 presented iso-signal intensity. On T1WI, 12 lesions presented slightly low-signal intensity, 7 presented iso-signal intensity, and the other 12 presented high-signal intensity. On opposed-phase, the signal intensity of 1 lesion dropped unevenly. After bolus injection of contrast agent Gd-DTPA, in hepatic arterial phase 18 lesions showed mild to marked heterogeneous enhancement, 11 showed marked homogeneous enhancement, 1 showed moderate ring-like enhancement, and the last one did not have obvious enhancement In portal venous and delayed phase, all the lesions turned to iso- or slightly high-signal intensity gradually. Sixteen of 31 lesions presented central scar, which demonstrated mild star-like enhancement in delayed phase. Conclusion Multiple FNH presented certain MRI features, which contributed to the preoperative diagnosis.