Objective To analyze the epidemic characteristics of scarlet fever in Pudong New Area, Shanghai from 2010 to 2023, and to grasp the incidence of scarlet fever in time. Methods The information on the registration of scarlet fever in Pudong New Area, Shanghai from January 1, 2010 to December 31, 2023 was collected through the China Disease Prevention and Control Information System, and descriptive epidemiological methods and Joinpoint regression model were used for data analysis. Results From 2010 to 2023, a total of 5 669 cases of scarlet fever were reported in Pudong New Area, Shanghai, and no deaths were reported. The annual reported incidence rate was 7.2/100 000, and the overall trend was decreasing year by year. In terms of time distribution, the incidence peaks were in spring and winter. The incidence rate in males was higher than that in females, and it mainly affected children, especially those aged 2 to 10 years. Joinpoint regression model analysis showed that the annual percentage change (APC) and average annual percentage change (AAPC) of the reported incidence rate of scarlet fever from 2010 to 2023 showed that the incidence rate was fluctuating, and the incidence rate decreased significantly from 2019 to 2023 (APC was -53.7%). Conclusion The reported incidence rate of scarlet fever in Pudong New Area in Shanghai has decreased year by year from 2010 to 2023, and children remain the focus of prevention and control.

ObjectiveTo investigate the whole genomic characteristics and phylogenetic relationships of clinical isolates of enteroaggregative Escherichia coli (EAEC) in diarrhea outpatients in Pudong New Area, Shanghai. MethodsBased on the diarrheal disease surveillance network in Pudong New Area, Shanghai, whole-genome sequencing was performed on a total of 55 EAEC strains isolated from fecal samples of the diarrhea outpatients from January 2015 to December 2019. The genome analyses based on raw sequencing data encompassed genome size, coding genes, dispersed repeat sequences, genomic islands, and protein coding regions, and pan-genome analyses were conducted simultaneously. Contigs sequences assays were performed to analyze molecular characteristics including serotypes, antibiotic resistance genes, and virulence factors. The phylogenetic clusters and multilocus sequence typing (MLST) were identified, and a phylogenetic tree was constructed. ResultsEAEC exhibited an open pan-genome. The predominant serotype of EAEC in diarrhea outpatients in Pudong New Area was O130:H27, and the carriage rate of β-lactam resistance genes was the highest (67.27%, 37/55). A total of 29 virulence factors and 106 virulence genes were identified, phylogenic group B1 was the predominant group, and clonal group CC31 was the dominant clonal group. The strain distribution was highly heterogeneous. ConclusionThe genomic characteristics of EAEC displayed significant strain polymorphism. It is necessary to develop effective strategies for differential diagnosis and improve detection capabilities for infection with EAEC of different serotypes and genotypes.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

OBJECTIVE: To evaluate the risks and benefits of different resuscitation fluids in patients with early sepsis and septic shock by observing and comparing clinical indicators, clinical outcomes, and the concentration changes of glycocalyx biomarkers, and to determine how to appropriately select suitable resuscitation fluids for sepsis patients to aid fluid therapy. METHODS: A single center, prospective, randomized controlled trial was conducted. Patients with early sepsis and septic shock who have required fluid resuscitation after capacity status assessment admitted to the department of critical care medicine of Fourth Hospital of Hebei Medical University from April to October 2023 were enrolled. Patients were randomly assigned to either the experimental group (balanced crystalloid solution+albumin) or the control group (balanced crystalloid solution) by a random number table method. Clinical data of both groups of patients before and after resuscitation at 3, 8, and 24 hours were monitored, and blood samples were collected, enzyme-linked immunosorbent assay (ELISA) was used to measure the concentration of plasma glycocalyx biomarker syndecan-1. The 28-day and 90-day survival rates and complications were also assessed. RESULTS: A total of 66 patients were enrolled, including 44 in the experimental group and 22 in the control group. The baseline data of two groups were balanced and comparable. There was no statistically significant difference in the plasma concentration of syndecan-1 between the experimental group and the control group before and after resuscitation, and both showed a trend of first increasing and then decreasing. However, the plasma syndecan-1 level in the control group at 8 hours and 24 hours after resuscitation were significantly higher than the baseline level before resuscitation [ng/L: 19.02 (14.41, 27.80), 18.95 (12.40, 22.50) vs. 14.67 (11.57, 21.14), both P < 0.05], while there was no statistically significant difference at any time point within the experimental group. The correlation analysis between plasma syndecan-1 level and lactic acid, albumin, and sequential organ failure assessment (SOFA) in all patients showed that a positive correlation between syndecan-1 level and SOFA score before resuscitation (r = 0.247, P = 0.046), and a negative correlation between syndecan-1 level and albumin level at 24 hours after resuscitation (r = -0.308, P = 0.012). There were no statistically significant differences in 28-day and 90-day mortality, length of hospital stay, length of intensive care unit (ICU) stay, duration of mechanical ventilation, blood purification time, number of organ injuries, and complications between the two groups. However, the baseline albumin level in the experimental group was significantly lower than that in the control group (g/L: 28.7±4.5 vs. 31.6±4.2, P < 0.05). Analysis of clinical treatment data showed that compared with the control group, the experimental group had lower absolute lactate level at 8 hours and 24 hours after resuscitation [mmol/L: 8 hours was 1.30 (1.00, 1.88) vs. 1.60 (1.30, 3.05), 24 hours was 1.15 (0.80, 1.78) vs. 1.55 (1.08, 2.05), both P < 0.05], and higher lactate clearance rate [8 hours was 45% (27%, 56%) vs. 20% (-4%, 46%), 24 hours was 55% (34%, 70%) vs. 34% (-14%, 59%), both P < 0.05]. However, there were no statistically significant differences in the amount of fluid resuscitation, use of vasoactive drugs, and oxygenation index between the two groups during the resuscitation process. Multivariate Logistic regression analysis showed that body mass index (BMI) was independently correlated with 90-day mortality [odds ratio (OR) = 1.991, 95% confidence interval (95%CI) was 1.023-3.387, P = 0.043]. CONCLUSIONS There are no significant difference in plasma syndecan-1 level during fluid resuscitation of early sepsis and septic shock patients using balanced crystalloid fluid and balanced crystalloid fluid combined with albumin resuscitation, and there are no statistically significant differences in the impact on 28-day and 90-day prognosis, length of hospital stay, complications, and other aspects of the patients. However, compared to balanced crystalloid fluid, the combination of balanced crystalloid fluid and albumin for fluid resuscitation in sepsis patients has lower lactate level and better lactate clearance effect, but further validation is still needed through large-scale randomized controlled trials.
Humans ; Clinical Relevance ; Crystalloid Solutions/administration & dosage* ; Fluid Therapy/methods* ; Glycocalyx/metabolism* ; Isotonic Solutions/administration & dosage* ; Prospective Studies ; Resuscitation/methods* ; Sepsis/therapy* ; Shock, Septic/therapy* ; Syndecan-1/blood*

Objectives:To investigate the relationship between pelvic landmarks on body surface and the trajectory of S2 alar-iliac(S2AI)screws in populations of different genders and body mass indexes.Methods:A retrospective analysis was conducted on 150 patients who underwent pelvic CT scans in the Affiliated Hospital of Southwest Medical University between February 2022 and February 2024.Basic demographic data including age,gender,weight,and height were collected.Pelvic models were reconstructed by CT,and screw trajectories were simulated on the models.The screw trajectories were extended to intersect with the skin sur-face,and the intersection points of the safe trajectories with skin formed a safety zone on the body surface.The shortest distances from the anterior superior iliac spine(ASIS),anterior inferior iliac spine(AIIS),and greater trochanter(GT)to the safe zone were measured.The length of the line connecting ASIS and GT on the surface,length of such line intersecting with the safety zone,length from ASIS to the safety zone along such line,length from GT to the safety zone along such line were measured.Group comparisons were performed based on gender and BMI[underweight group(BMI＜18.50kg/m2),normal group(18.50kg/m2≤BMI＜24.00kg/m2),overweight group(24.00kg/m2≤BMI＜28.00kg/m2),obese group(BMI≥28.00kg/m2)].Results:In males,the shortest distances from ASIS,AIIS,and GT to the safe zone were 19.87±3.66mm,33.66±3.33mm,and 39.53±3.56mm,respectively;In females,they were 19.31±3.41mm,33.23±3.45mm,and 38.74±3.23mm,respectively.No statis-tically significant differences were observed between gender groups(P＞0.05).The shortest distance from ASIS,AIIS,GT to safety zone was 14.03±1.64mm,26.79±1.15mm,43.68±1.32mm in the underweight group,17.67±2.36mm,31.73±1.77mm,41.18±2.43mm in the normal group,21.85±1.37mm,35.78±1.76mm,36.80±1.68mm in the overweight group,and 25.66±0.84mm,38.75±0.88mm,and 36.80±1.68mm in the obese group,respec-tively.Intergroup comparisons between the four groups were statistically significant(P＜0.05),and pairwise com-parisons within groups were statistically significant(P＜0.05).In males,the length of the line connecting ASIS and GT was 129.43±6.42mm,the length of the line intersecting with safety zone was 30.72±5.27mm,the length from ASIS to safety zone along the line was 33.61±8.82mm,and the length from GT to safety zone a-long the line was 69.14±11.46mm;In females,such lengths were 109.83±8.99mm,32.32±4.94mm,35.77±11.26mm,and 43.75±7.62mm,respectively,with significant differences between the two gender groups(P＜0.05);In the underweight group,such distances were 119.40±12.21mm,30.72±3.83mm,25.42±7.75mm,and 65.64±14.79mm;In the normal weight group,they were 122.98±10.91mm,30.29±4.29mm,35.01±10.22mm,and 60.58±13.43mm;In the overweight group,they were 117.52±13.70mm,32.12±6.27mm,36.92±8.27mm,and 51.42±18.38mm;In the obese group,they were 120.52±13.95mm,35.65±3.29mm,29.58±11.67mm,and 60.93±15.13mm.The length of the line connecting ASIS and GT showed no statistically significant difference be-tween weight subgroups(P＞0.05).However,the length of the line intersecting with the safety zone,the length from ASIS to the safety zone along the line,and the length from GT to the safety zone along the line exhib-ited statistically significant differences between subgroups(P＜0.05).Conclusions:All the S2AI screw safety channels targets a specific area on the body surface,and the line connecting the anterior superior iliac spine and greater trochanter(GT)passes through this safety zone,which can serve as an auxiliary landmark for plac-ing the S2AI screw.

Objective To analyze the results of human-machine coupling quality control(QC)for inpatient medical re-cords,compare them with manual QC results,and evaluate the value of the human-machine coupling approach.Methods Dis-charge medical records from a tertiary hospital between January 1,2024,and November 30,2024,underwent QC via two meth-ods:human-machine coupling QC and manual QC.Manual QC was performed based on medical record documentation standards and medical record management quality control indicators.The differences in the results obtained by human-machine coupling QC and manual QC were statistically analyzed.Results The human-machine coupling method reviewed 76 204 medical records,i-dentifying 204 544 issues.Manual QC reviewed 521 records,identifying 2 032 issues.The identified problems were categorized into five types:documentation,diagnosis and treatment,front page(administrative data),communication documents,and ap-proval documents.Conclusion Rule-based human-machine coupling QC achieves comprehensive and full-process coverage of inpatient medical records.The generated QC reports can display the distribution and correction status of detected issues,provi-ding a basis and direction for hospital management.

Objective:To explore different types of psychological reactions of spouses of young and middle-aged breast cancer patients and their influencing factors based on potential profile analysis, so as to provide reference for targeted intervention in clinical practice.Methods:A cross-sectional investigation method was used to select the spouses of middle-aged and young patients with breast cancer who were hospitalized in the Second Affiliated Hospital of Guilin Medical University, Quanzhou County People's Hospital, and Bobai County People's Hospital from January 2023 to June 2024. General Data Questionnaire, Spousal Psychological Response Scale of Breast Cancer Patients, Perceived Partner Responsiveness Scale and Perceptive Social Support Scale were used to investigate. The potential profile analysis of spousal psychological reaction of young and middle-aged breast cancer patients was carried out, and the influencing factors of different categories were analyzed by ordered multiple Logistic regression.Results:A total of 232 questionnaires were distributed, and 211 valid questionnaires were collected, with an effective response rate of 91.0%.The spouses of 211 middle-aged and young patients with breast cancer were 30-59 (43.25 ± 2.58) years old. The total psychological response score was (69.96 ± 8.36). The low psychological response high coping group accounted for 24.6% (52/211), the moderate psychological response group accounted for 33.2% (70/211), and the high psychological response low coping group accounted for 42.2% (89/211). The results of ordered multiple Logistic regression analysis showed that cumulative care time, tumor stage of patients, perceived partner responsiveness, and perceived social support were the influencing factors of potential categories of psychological responses of spouses of young and middle-aged breast cancer patients ( OR values were 0.014-0.304, all P<0.05). Conclusions:There is heterogeneity in the psychological reactions of spouses of young and middle-aged breast cancer patients. According to the characteristics of the classification, the nursing staff should formulate targeted intervention strategies, focusing on improving the perceived partner responsiveness, establishing an effective social support system, and reducing the level of psychological response.

Objective To analyze the results of human-machine coupling quality control(QC)for inpatient medical re-cords,compare them with manual QC results,and evaluate the value of the human-machine coupling approach.Methods Dis-charge medical records from a tertiary hospital between January 1,2024,and November 30,2024,underwent QC via two meth-ods:human-machine coupling QC and manual QC.Manual QC was performed based on medical record documentation standards and medical record management quality control indicators.The differences in the results obtained by human-machine coupling QC and manual QC were statistically analyzed.Results The human-machine coupling method reviewed 76 204 medical records,i-dentifying 204 544 issues.Manual QC reviewed 521 records,identifying 2 032 issues.The identified problems were categorized into five types:documentation,diagnosis and treatment,front page(administrative data),communication documents,and ap-proval documents.Conclusion Rule-based human-machine coupling QC achieves comprehensive and full-process coverage of inpatient medical records.The generated QC reports can display the distribution and correction status of detected issues,provi-ding a basis and direction for hospital management.

Objectives:To investigate the relationship between pelvic landmarks on body surface and the trajectory of S2 alar-iliac(S2AI)screws in populations of different genders and body mass indexes.Methods:A retrospective analysis was conducted on 150 patients who underwent pelvic CT scans in the Affiliated Hospital of Southwest Medical University between February 2022 and February 2024.Basic demographic data including age,gender,weight,and height were collected.Pelvic models were reconstructed by CT,and screw trajectories were simulated on the models.The screw trajectories were extended to intersect with the skin sur-face,and the intersection points of the safe trajectories with skin formed a safety zone on the body surface.The shortest distances from the anterior superior iliac spine(ASIS),anterior inferior iliac spine(AIIS),and greater trochanter(GT)to the safe zone were measured.The length of the line connecting ASIS and GT on the surface,length of such line intersecting with the safety zone,length from ASIS to the safety zone along such line,length from GT to the safety zone along such line were measured.Group comparisons were performed based on gender and BMI[underweight group(BMI＜18.50kg/m2),normal group(18.50kg/m2≤BMI＜24.00kg/m2),overweight group(24.00kg/m2≤BMI＜28.00kg/m2),obese group(BMI≥28.00kg/m2)].Results:In males,the shortest distances from ASIS,AIIS,and GT to the safe zone were 19.87±3.66mm,33.66±3.33mm,and 39.53±3.56mm,respectively;In females,they were 19.31±3.41mm,33.23±3.45mm,and 38.74±3.23mm,respectively.No statis-tically significant differences were observed between gender groups(P＞0.05).The shortest distance from ASIS,AIIS,GT to safety zone was 14.03±1.64mm,26.79±1.15mm,43.68±1.32mm in the underweight group,17.67±2.36mm,31.73±1.77mm,41.18±2.43mm in the normal group,21.85±1.37mm,35.78±1.76mm,36.80±1.68mm in the overweight group,and 25.66±0.84mm,38.75±0.88mm,and 36.80±1.68mm in the obese group,respec-tively.Intergroup comparisons between the four groups were statistically significant(P＜0.05),and pairwise com-parisons within groups were statistically significant(P＜0.05).In males,the length of the line connecting ASIS and GT was 129.43±6.42mm,the length of the line intersecting with safety zone was 30.72±5.27mm,the length from ASIS to safety zone along the line was 33.61±8.82mm,and the length from GT to safety zone a-long the line was 69.14±11.46mm;In females,such lengths were 109.83±8.99mm,32.32±4.94mm,35.77±11.26mm,and 43.75±7.62mm,respectively,with significant differences between the two gender groups(P＜0.05);In the underweight group,such distances were 119.40±12.21mm,30.72±3.83mm,25.42±7.75mm,and 65.64±14.79mm;In the normal weight group,they were 122.98±10.91mm,30.29±4.29mm,35.01±10.22mm,and 60.58±13.43mm;In the overweight group,they were 117.52±13.70mm,32.12±6.27mm,36.92±8.27mm,and 51.42±18.38mm;In the obese group,they were 120.52±13.95mm,35.65±3.29mm,29.58±11.67mm,and 60.93±15.13mm.The length of the line connecting ASIS and GT showed no statistically significant difference be-tween weight subgroups(P＞0.05).However,the length of the line intersecting with the safety zone,the length from ASIS to the safety zone along the line,and the length from GT to the safety zone along the line exhib-ited statistically significant differences between subgroups(P＜0.05).Conclusions:All the S2AI screw safety channels targets a specific area on the body surface,and the line connecting the anterior superior iliac spine and greater trochanter(GT)passes through this safety zone,which can serve as an auxiliary landmark for plac-ing the S2AI screw.

Objective:To explore different types of psychological reactions of spouses of young and middle-aged breast cancer patients and their influencing factors based on potential profile analysis, so as to provide reference for targeted intervention in clinical practice.Methods:A cross-sectional investigation method was used to select the spouses of middle-aged and young patients with breast cancer who were hospitalized in the Second Affiliated Hospital of Guilin Medical University, Quanzhou County People's Hospital, and Bobai County People's Hospital from January 2023 to June 2024. General Data Questionnaire, Spousal Psychological Response Scale of Breast Cancer Patients, Perceived Partner Responsiveness Scale and Perceptive Social Support Scale were used to investigate. The potential profile analysis of spousal psychological reaction of young and middle-aged breast cancer patients was carried out, and the influencing factors of different categories were analyzed by ordered multiple Logistic regression.Results:A total of 232 questionnaires were distributed, and 211 valid questionnaires were collected, with an effective response rate of 91.0%.The spouses of 211 middle-aged and young patients with breast cancer were 30-59 (43.25 ± 2.58) years old. The total psychological response score was (69.96 ± 8.36). The low psychological response high coping group accounted for 24.6% (52/211), the moderate psychological response group accounted for 33.2% (70/211), and the high psychological response low coping group accounted for 42.2% (89/211). The results of ordered multiple Logistic regression analysis showed that cumulative care time, tumor stage of patients, perceived partner responsiveness, and perceived social support were the influencing factors of potential categories of psychological responses of spouses of young and middle-aged breast cancer patients ( OR values were 0.014-0.304, all P<0.05). Conclusions:There is heterogeneity in the psychological reactions of spouses of young and middle-aged breast cancer patients. According to the characteristics of the classification, the nursing staff should formulate targeted intervention strategies, focusing on improving the perceived partner responsiveness, establishing an effective social support system, and reducing the level of psychological response.