Objective To explore an artificial intelligence (AI)-based method for automated hand hygiene monitoring and to compare the effectiveness of three algorithms (UniFormerV2, TDN, C3D) in recognizing hand hygiene steps in surgical settings, thereby aiding hospital infection control. Methods From April to October 2024, we non-invasively collected 641 video recordings of healthcare staff performing hand hygiene at four-bay scrub sinks in two tertiary hospitals using overhead HD cameras. The dataset was annotated by five trained experts for model training and validation. Results Following training on 385 samples, internal validation (n=119) showed the C3D model achieved 81% accuracy, 87% recall, and an 83% F1-score. The TDN model achieved 93%, 91%, and 92% for the same metrics. The UniFormerV2 model outperformed both, with an accuracy, recall, and F1-score of 93%—an improvement of over 10 percentage points compared to traditional CNNs (TDN, C3D). It also achieved an 84% accuracy in external validation, demonstrating strong generalization. Conclusion The UniFormerV2 model is more accurate than CNN-based models for hand hygiene step recognition and shows robust performance in external validation. It presents a viable tool for healthcare facilities to enhance hand hygiene management, ultimately improving medical quality and patient safety.

Curzerene, a sesquiterpene compound isolated from Curcuma Radix, exhibits various therapeutic effects, such as anti-tumor and anti-hyperlipidemic properties. However, its neuroprotective effects have not yet been reported. This study focused on exploring the neuroprotective effect of curzerene and elucidating its potential mechanism by combining molecular biotechnology with multi-omics approaches. Curzerene was orally administered to LPS-induced depressive-like behaviors and cognitive impairment in mice for 14 days, and the related biochemical parameters were evaluated. The possible mechanisms were elucidated using qRT-PCR, Western Blot, immunofluorescence, untargeted metabolomics, GC-MS and 16S rDNA comprehensively. Curzerene ameliorated depression symptoms and cognitive impairment by increasing the preference for sucrose in SPT and the central area and total distance traveled in OFT, reducing the immobility time in TST and FST, as well as rising the spontaneous alternation ratio in Y maze. Multiple molecular biology techniques analyses indicated the ameliorative effect of curzerene via HMGB1/RAGE/ TLR4 pathway. Moreover, curzerene primarily regulates purine metabolism, phenylalanine, tyrosine and tryptophan biosynthesis, phenylalanine metabolism, pyrimidine metabolism, etc. Furthermore, intervention increased the relative abundance of Parabacteroides, Clostridia_UCG-014_unclassified, and Rhodospirillales_unclassified, and enhanced the production of SCFAs. This work demonstrated that curzerene effectively protects against LPS-induced neurological damage, potentially by inhibiting the HMGB1/ RAGE/TLR4 pathway through the restoration of gut microbiota homeostasis, modulation of metabolites, and enhancement of SCFAs. In conclusion, this study offers new perspectives on the therapeutic possibilities of curzerene in mitigating depressive-like behaviors and cognitive impairment.

Amyotrophic lateral sclerosis (ALS) is a chronic, progressive degenerative disease affecting both upper and lower motor neurons, primarily characterized by skeletal muscle weakness and atrophy. Notably, the same muscle group may exhibit asynchronous involvement. This study aims to investigate the involvement patterns of the orbicularis oculi (OOc) and orbicularis oris (OOr) in ALS patients, compare the findings with healthy controls (HCs) and myasthenia gravis (MG) patients, and explore the characteristics and clinical significance of facial muscle involvement in ALS.

Objective To investigate the clinical effect of far lateral approach surgery under unilateral biportal endoscope(UBE)for lumbar foraminal stenosis.Methods From June 2021 to August 2022,39 patients with lumbar foraminal stenosis were treated with far lateral approach surgery under UBE in our department.The patients were placed at the standard prone position,and a longitudinal line was drawn about 2 cm from the lateral edge of the upper and lower pedicles.Transverse incisions were made at the two intersection points of the horizontal line at the midpoint of the lateral edge of the upper and lower pedicles.After inserting the gradually enlarged sleeves to expand the space,the enlargement of the intervertebral foramen and release of the nerve root were completed under the direct view of UBE.The Visual Analogue Scale(VAS)of leg pain and the Oswestry Disability Index(ODI)were compared before and after operation.The effectiveness was evaluated according to the modified MacNab criteria at 12 months after operation.Results The operations were successfully completed in all the 39 cases.The operation time was(105.5±14.8)min,and the blood loss was(26.7±8.8)ml.The tear of adventitial nerve root occurred in 1 case during operation,and there was no nerve injury symptom after operation.One case of suspected infection occurred after operation and recovered after conservative treatment.All the 39 patients got out of bed with waist circumference on the first day after operation.The intervertebral foramen height measured by sagittal CT at 3 d after operation was(1.62±0.26)cm,which was significantly higher than that before operation[(1.51±0.28)cm;t=-4.010,P=0.000].The intervertebral foramen width was significantly greater than preoperation[(1.24±0.17)cm vs.(0.96±0.15)cm;t=-14.811,P=0.000].The area of intervertebral foramen was significantly larger than preoperation[(1.40±0.19)cm2 vs.(1.05±0.22)cm2;t=-12.874,P=0.000].The VAS of leg pain at 1 d,and 1,3,and 6 months after operation were significantly lower than those before operation(all P=0.000),and the VAS scores gradually decreased with the increase of time.The ODI was significantly lower at 1,3,and 6 months after operation than that before operation(all P=0.000),and the ODI decreased gradually with the increase of time.According to the modified MacNab criteria,at 12 months after operation,33 cases were excellent,4 cases were good,and 2 cases were fair,with an excellent and good rate of 94.9％(37/39).Conclusions Far lateral approach surgery under UBE for lumbar foraminal stenosis has significant effect on the relief of lumbago and leg pain and the improvement of lumbar function.It has little damage to lumbar stability and does not need internal fixation,which is worthy of clinical application and promotion.

Objective:To understand the distribution of pediatric medical resources and development status within the healthcare institutions of the pediatric alliance in Jilin Province，and to propose practical strategies for promoting high-quality development in pediatric specialties in the region.Methods:The study utilized the Wenjuanxing (a web-based survey platform) to distribute electronic questionnaires to pediatric department heads from 93 alliance-affiliated healthcare institutions. The survey collected data on human resources，outpatient/emergency services，intensive care unit (ICU) capacity，hospital facilities and equipment，and technological capabilities across these institutions from January to December 2023.Results:Among the 93 medical institutions，22 (23.66%) were classified as Grade Ⅲ-A hospitals，53（56.99%）had independent pediatric departments and emergency departments，and 26（27.96%）did not have independent pediatric wards.There were 1 327 pediatricians，including 537 with intermediate professional title（40.47%）and 668 with undergraduate degree（50.34%）.Facilities，equipment，and pediatric technical capabilities varied markedly among institutions in Jilin Province.Conclusion:The professional development of pediatrics in various medical institutions in Jilin Province is uneven，the ability gap is large，and the sources of high-quality medical funding are relatively concentrated.The high-quality development of pediatrics in Jilin Province is still facing great challenges.

Objective Based on the SWOT analysis method,the temporary medical order dispensing service model of pharmacy intravenous admixture service(PIVAS)of M Hospital was constructed and its implementation effect was evaluated,so as to provide reference for other medical institutions to carry out PIVAS temporary dispensing services.Methods SWOT analysis was used to analyze the advantages,disadvantages,opportunities and threats of PIVAS in M Hospital,and targeted operation strategies and practices were proposed.The safety of intravenous medication,the level of pharmacy service and the cost-effectiveness of the department were used to evaluate the implementation effect of PIVAS temporary medical order dispensing service.Results After the operation strategy of PIVAS temporary medical order dispensing service was constructed and implemented based on SWOT analysis,the time of a single medical order for PIVAS labeling in M Hospital was significantly decreased from(7.19±0.06)s/bag to(6.06±0.09)s/bag(P＜0.05);and the number of errors was significantly reduced from(32.50±2.54)pieces/quarter to(19.75±0.59)pieces/quarter(P＜0.05);The qualified rate of temporary prescription increased from(60.52±1.17)％to(90.63±1.72)％(P＜0.05);The qualified rate of finished infusion delivery time increased from(80.63±1.66)％to(90.80±2.98)％(P＜0.05);The satisfaction rate of PIVAS service in the ward increased from 50％to 90％(P＜0.05);the cost of blending decreased from(3.50±0.05)yuan/bag to(3.00±0.12)yuan/bag(P＜0.05).Conclusion The operation strategy of PIVAS temporary medical order dispensing service of M Hospital based on SWOT analysis gives full play to its own advantages,provides more comprehensive and high-quality services for clinicians and patients,ensures the safety and timeliness of patients' medication,and improves the economic efficiency of the department,which is worthy of reference and promotion.

Objective Based on the theory of"stomach disharmony leads to restlessness",the causal relationship between gastroesophageal reflux disease and insomnia was discussed by Mendel randomization method with two samples.Methods The data were collected from genome-wide association studies,the exposure factor was gastroesophageal reflux disease,and the outcome variable was insomnia.Mendel randomization analysis is realized by inverse variance weighted method,MR-Egger method,simple model method,weighted model method and weighted median method.Sensitivity analysis includes pleiotropic test,heterogeneity test and one-by-one elimination test,and is calculated by MR-Egger method,Cochran Q test and one-out-of-one method in turn.Results A total of 75 single nucleotide polymorphisms(SNPs)were screened.The inverse variance weighted method showed that gastroesophageal reflux disease increased the risk of insomnia(OR=1.255,95%CI:1.071-1.470,P<0.05).The weighted median method also confirmed that there was a positive causal relationship between gastroesophageal reflux disease and insomnia(OR=1.403,95%CI:1.117-1.762,P<0.05).Multiple sensitivity analysis indicated that there was no pleiotropy and heterogeneity in the results of Mendelian randomized analysis,which verified the stability of the research results.Conclusion There is a positive causal relationship between gastroesophageal reflux disease and insomnia,which enriches the theoretical connotation of"stomach disharmony leads to restlessness"from the genetic point of view and lays a foundation for further study.

Objective To investigate the clinical effect of far lateral approach surgery under unilateral biportal endoscope(UBE)for lumbar foraminal stenosis.Methods From June 2021 to August 2022,39 patients with lumbar foraminal stenosis were treated with far lateral approach surgery under UBE in our department.The patients were placed at the standard prone position,and a longitudinal line was drawn about 2 cm from the lateral edge of the upper and lower pedicles.Transverse incisions were made at the two intersection points of the horizontal line at the midpoint of the lateral edge of the upper and lower pedicles.After inserting the gradually enlarged sleeves to expand the space,the enlargement of the intervertebral foramen and release of the nerve root were completed under the direct view of UBE.The Visual Analogue Scale(VAS)of leg pain and the Oswestry Disability Index(ODI)were compared before and after operation.The effectiveness was evaluated according to the modified MacNab criteria at 12 months after operation.Results The operations were successfully completed in all the 39 cases.The operation time was(105.5±14.8)min,and the blood loss was(26.7±8.8)ml.The tear of adventitial nerve root occurred in 1 case during operation,and there was no nerve injury symptom after operation.One case of suspected infection occurred after operation and recovered after conservative treatment.All the 39 patients got out of bed with waist circumference on the first day after operation.The intervertebral foramen height measured by sagittal CT at 3 d after operation was(1.62±0.26)cm,which was significantly higher than that before operation[(1.51±0.28)cm;t=-4.010,P=0.000].The intervertebral foramen width was significantly greater than preoperation[(1.24±0.17)cm vs.(0.96±0.15)cm;t=-14.811,P=0.000].The area of intervertebral foramen was significantly larger than preoperation[(1.40±0.19)cm2 vs.(1.05±0.22)cm2;t=-12.874,P=0.000].The VAS of leg pain at 1 d,and 1,3,and 6 months after operation were significantly lower than those before operation(all P=0.000),and the VAS scores gradually decreased with the increase of time.The ODI was significantly lower at 1,3,and 6 months after operation than that before operation(all P=0.000),and the ODI decreased gradually with the increase of time.According to the modified MacNab criteria,at 12 months after operation,33 cases were excellent,4 cases were good,and 2 cases were fair,with an excellent and good rate of 94.9％(37/39).Conclusions Far lateral approach surgery under UBE for lumbar foraminal stenosis has significant effect on the relief of lumbago and leg pain and the improvement of lumbar function.It has little damage to lumbar stability and does not need internal fixation,which is worthy of clinical application and promotion.

To understand the pathogenicity and drug resistance of swine-derived E.coli and its bio-logical characteristics in some areas in Hebei,E.coli was isolated and identified from diarrheal fe-ces of piglets collected from swine farms,and the isolated strains were subjected to drug sensitivity test,detection of the ability to form biofilm,pathogenicity test,virulence gene test,drug resistance gene test,and identification of phylogenetic subgroups.The results showed that a total of 35 patho-genic E.coli strains were isolated from the feces of diarrheic piglets,and most of the isolates were multidrug-resistant,and were resistant to at least three antibiotics,including amoxicillin(88.57％),ampicillin(88.57％),doxycycline(88.75％),sulfisoxazole(77.17％),lincomycin(100％),and chloramphenicol(100％);the isolates were severely resistant.The isolates all carried virulence genes,with a total of five virulence genes detected,namely,EAST1(77.14％),eaeA(17.14％),stx2e(5.71％),LT(2.86％),and STb(2.86％),and the isolates also carried multi-re-sistance genes,with a total of five virulence genes detected,namely,bla TEM-1(65.71％),bla CTX-M(20.00％),tetA(82.86％),tetB(14.29％),aadA2(17.14％),aac(6')-Ib(14.29％),qnrS(17.14％),sul 1(40.00％),sul2(34.29％),and floR(60.00％);the phylogenetic grouping showed that the isolates had a high proportion of group B1 and group A;and all 35 isolates showed differ-ent pathogenicity after infection of mice.This study provides a reference for the selection of effec-tive therapeutic drugs and the development of prevention and control programs for swine-origin pathogenic E.coli in Hebei Province.

To understand the pathogenicity and drug resistance of swine-derived E.coli and its bio-logical characteristics in some areas in Hebei,E.coli was isolated and identified from diarrheal fe-ces of piglets collected from swine farms,and the isolated strains were subjected to drug sensitivity test,detection of the ability to form biofilm,pathogenicity test,virulence gene test,drug resistance gene test,and identification of phylogenetic subgroups.The results showed that a total of 35 patho-genic E.coli strains were isolated from the feces of diarrheic piglets,and most of the isolates were multidrug-resistant,and were resistant to at least three antibiotics,including amoxicillin(88.57％),ampicillin(88.57％),doxycycline(88.75％),sulfisoxazole(77.17％),lincomycin(100％),and chloramphenicol(100％);the isolates were severely resistant.The isolates all carried virulence genes,with a total of five virulence genes detected,namely,EAST1(77.14％),eaeA(17.14％),stx2e(5.71％),LT(2.86％),and STb(2.86％),and the isolates also carried multi-re-sistance genes,with a total of five virulence genes detected,namely,bla TEM-1(65.71％),bla CTX-M(20.00％),tetA(82.86％),tetB(14.29％),aadA2(17.14％),aac(6')-Ib(14.29％),qnrS(17.14％),sul 1(40.00％),sul2(34.29％),and floR(60.00％);the phylogenetic grouping showed that the isolates had a high proportion of group B1 and group A;and all 35 isolates showed differ-ent pathogenicity after infection of mice.This study provides a reference for the selection of effec-tive therapeutic drugs and the development of prevention and control programs for swine-origin pathogenic E.coli in Hebei Province.