This report described a case of neonatal alloimmune thrombocytopenic purpura presenting with generalized petechiae. The infant was admitted at Nanfang Hospital, Southern Medical University on March 30, 2022, following detection of wide spread petechiae 30 minutes post-delivery. Blood tests revealed severe thrombocytopenia (platelet count 5×10 9/L) with leukopenia, decreased hemoglobin, and hepatomegaly, though coagulation function remained normal. Initial treatments—random donor platelet transfusion, and intravenous immunoglobulin—proved ineffective. Pretreatment blood samples showed strongly positive platelet antibodies (3+). Further typing confirmed human leukocyte antigen (HLA) antibodies in both infant and mother, establishing HLA-negative neonatal alloimmune thrombocytopenia. HLA-negative platelet transfusion resolved petechiae and normalized platelet counts, enabling discharge on postnatal day 14. Subdural hemorrhage was detected on MRI at day 29. Platelet levels remained normal at six-month follow-up, with age-appropriate development confirmed at 2.5 years.

Objective To investigate the mediating effect of psychological flexibility on the relationship between pain self-efficacy and kinesiophobia in patients with lumbar disc herniation(LDH),so as to provide references for relief from kinesiophobia of the patients.Methods Convenience sampling was used to select 256 patients with LDH as the research subjects from the Outpatient Department of Spinal Orthopaedics of a Grade IIIA hospital in Guangdong Province between May and December 2023.The subjects were surveyed with a general information questionnaire,the kinesiophobia assessment scale,psychological flexibility inventory for pain patients,and chronic pain self-efficacy scale.The mediation effect of psychological flexibility on pain self-efficacy and kinesiophobia was analysed using SPSS 26.0 and the PROCESS 3.5 macro.Results The scores for kinesiophobia,psychological flexibility and pain self-efficacy among the LDH patients were 31.66±4.73,55.26±11.06 and 68.14±17.48,respectively.Kinesiophobia was positively correlated with the psychological flexibility(r=0.545,P<0.001)and negatively correlated with the pain self-efficacy(r=-0.599,P<0.001).The psychological flexibility was negatively correlated with the pain self-efficacy(r=-0.510,P<0.001).Psychological flexibility partially mediated the relationship between pain self-efficacy and kinesiophobia,with a mediating effect of-0.045,accounting for 27.78%of the total effect.Conclusion The patients who have LDH and under conservative treatment exhibit a high level of kinesiophobia and with a moderate levels of pain self-efficacy and psychological flexibility.The medical staff can improve the self-efficacy and psychological flexibility of patients,so as to reduce kinesiophobia level and its incidence.

OBJECTIVE To investigate the current status of contamination with carbapenem-resistant gram-negative bacteria in environment of intensive care units(ICU)of tertiary hospitals in Shanghai and find out the potential contamination sources so as to provide bases for prevention and control of multidrug-resistant organisms infec-tions in the ICUs.METHODS The surroundings of the ICU patients detected with CRGNB and environmental ob-jects surfaces in public area were sampled by mSuperCARBA chromogenic media from Dec.2024 to Jan.2025,the strains were isolated,and the targeted strains were identified by matrix-assisted laser desorption/ionization time-of-flight(MALDI-TOF)mass spectrometer.RESULTS A total of 653 samples were collected in the survey,76 of which were positive for bacterial culture,60 were detected with CRGNB,and the isolation rate of CRGNB was 9.19％.The isolation rate of CRGNB was 53.40％in the water-source group,0.91％in the non-water-source group,and there was significant difference(x2=286.450,P＜0.001).The result of whole genome sequencing for 17 strains of CRKP showed that ST11 and ST15 were the two major types of multilocus typing(MT),respective-ly carrying 2-12 types of drug resistance genes.CONCLUSIONS The CRGNB strains are detected in some environ-mental sites of the ICUs of 15 tertiary hospitals in Shanghai,and the isolation rate of CRKP is highest among them.The colonization rate of CRGNB is relatively low on the highly frequent-contact object surfaces of the ICUs,however,sink drain holes poses a risk of hospital-acquired CRGNB infections transmissions.Additionally,the ba-sins and towels of the CRGNB patients are hard to be thoroughly cleaned,disinfected and dried,resulting in a high contamination rate.

Objective To analyze the current situation of pediatric CT examination protection and cognition in Linyi City, China, and to promote the safe and standardized development of pediatric CT examination. Methods The radiation protection facilities of 58 medical institutions, the use of protective equipment among 158 pediatric patients undergoing CT examinations, and the cognition of radiation knowledge by 188 radiographers were investigated, and the data were analyzed. Results All 58 medical institutions installed ionizing radiation warning signs according to the standards, the normal operation rate of the work indicator lights was 81.0%, and the proper provision rate of protective equipment was 72.4%. The utilization rate of protective equipment was 59.5%, and there were significant differences among hospitals at different levels (P < 0.05). Radiographers had the highest awareness rate of radiation hazards (93.6%). The awareness rate of radiation basic knowledge differed significantly among radiographers with variuos educational backgrounds and professional titles (P < 0.05). The awareness rate of protection knowledge differed significantly with sex, age, and professional title (P < 0.05). There were significant differences in the awareness rate of emergency knowledge and laws and regulations based on age, educational background, and professional title (P < 0.05). Conclusion The availability and utilization of protective facilities and equipment for pediatric CT examinations in medical institutions in Linyi City require further improvement. Radiographers have a high level of awareness of radiation hazards. However, there remain gaps in their awareness rates of fundamental radiation hygiene knowledge, radiation protection knowledge, emergency knowledge, and laws and regulations. Increased efforts in education and training are recommended.

Objective To investigate the predictive value of dual-energy computed tomography(DECT)quantitative parameters in the diagnosis and pathological aggressiveness of lung adenocarcinoma.Methods A total of 174 patients with lung cancer were pro-spectively selected.All patients underwent DECT examination,and the types of lung cancer were determined according to the patho-logical tissue.According to the pathological classification,they were divided into lung adenocarcinoma group(n=99),lung squamous cell carcinoma group(n=47)and small cell lung cancer group(n=28).According to whether the lung adenocarcinoma patients had pathological aggressiveness,they were divided into invasive group(n=34)and non-invasive group(n=65).Receiver operating char-acteristic(ROC)curve was used to diagnose the predictive value of DECT quantitative parameters in the diagnosis and pathological aggressiveness of lung adenocarcinoma.Results The normalized iodine concentration(NIC)and k in venous phase of lung adenocar-cinoma group were higher than those in lung squamous cell carcinoma group and small cell lung cancer group(P<0.05).ROC curve analysis showed that the combined diagnosis value of NIC and k in venous phase was higher(P<0.05).The lobular proportion,vac-uolar proportion,pleural indentation proportion,vascular cluster proportion,effective atomic number(Eff-Z),NIC and k in arterial phase,and NIC and k in venous phase in invasion group were higher than those in non-invasion group(P<0.05).Logistic regression analysis showed that pleural indentation,NIC in arterial phase and NIC in venous phase were risk factors for pathological aggerssive-ness in lung adenocarcinoma patients(P<0.05).ROC curve analysis showed that the combination of NIC in arterial phase and NIC in venous phase had higher value in predicting the pathological aggressiveness of lung adenocarcinoma(P<0.05).Conclusion The combination of NIC and k in venous phase is effective in the diagnosis of lung adenocarcinoma,while NIC in arterial phase and NIC in venous phase have high predictive values for the aggressiveness of lung adenocarcinoma.

Objective:To investigate the prevalence and influencing factors of kinesiophobia in chronic pain patients undergoing conservative treatment for lumbar disc herniation (LDH), providing reference and basis for reducing the occurrence of kinesiophobia in this patient population.Methods:A cross-sectional study was conducted from May 2023 to January 2024. A convenience sample of chronic pain patients undergoing conservative treatment for LDH in Guangdong Second Provincial General Hospital was selected as the study population. Data were collected by the general information questionnaire, Numerical Rating Scale, Tampa Scale of Kinesiophobia-11, Psychological Inflexibility in Pain Scale, and Chronic Pain Self-efficacy Scale. A random forest model was constructed to rank variable importance, and binary Logistic regression was used to analyze the influencing factors of kinesiophobia.Results:The effective response rate of the questionnaire was 96.8% (270/279). Among 270 patients, there were 139 males and 131 females, 92 patients aged 18-40 years, 132 patients aged 41-60 years, and 46 patients aged >60 years old. The total kinesiophobia score for chronic pain patients undergoing conservative treatment for LDH was (31.00 ± 5.09) points, with a kinesiophobia prevalence of 79.6% (215/270). The random forest algorithm identified eight influencing factors: pain self-efficacy, psychological flexibility, physical exercise after low back pain onset, duration of pain, pain status, understanding of LDH, marital status, and pain intensity. Binary Logistic regression analysis showed that physical exercise after low back pain onset ( OR=0.583, 95% CI 0.344-0.986), pain status ( OR=0.424, 95% CI 0.206-0.873), psychological flexibility ( OR=1.102, 95% CI 1.052-1.155), pain self-efficacy ( OR=0.923, 95% CI 0.895-0.953) were significant influencing factors of kinesiophobia in chronic pain patients undergoing conservative treatment for LDH (all P<0.05). Conclusions:The prevalence of kinesiophobia is high among chronic pain patients undergoing conservative treatment for LDH. Physical exercise after low back pain onset, pain status, psychological flexibility, and pain self-efficacy are significant influencing factors. Healthcare professionals should pay increased attention to kinesiophobia in chronic pain patients undergoing conservative treatment for LDH and implement targeted early interventions to reduce its occurrence.

Objective To investigate the predictive value of dual-energy computed tomography(DECT)quantitative parameters in the diagnosis and pathological aggressiveness of lung adenocarcinoma.Methods A total of 174 patients with lung cancer were pro-spectively selected.All patients underwent DECT examination,and the types of lung cancer were determined according to the patho-logical tissue.According to the pathological classification,they were divided into lung adenocarcinoma group(n=99),lung squamous cell carcinoma group(n=47)and small cell lung cancer group(n=28).According to whether the lung adenocarcinoma patients had pathological aggressiveness,they were divided into invasive group(n=34)and non-invasive group(n=65).Receiver operating char-acteristic(ROC)curve was used to diagnose the predictive value of DECT quantitative parameters in the diagnosis and pathological aggressiveness of lung adenocarcinoma.Results The normalized iodine concentration(NIC)and k in venous phase of lung adenocar-cinoma group were higher than those in lung squamous cell carcinoma group and small cell lung cancer group(P<0.05).ROC curve analysis showed that the combined diagnosis value of NIC and k in venous phase was higher(P<0.05).The lobular proportion,vac-uolar proportion,pleural indentation proportion,vascular cluster proportion,effective atomic number(Eff-Z),NIC and k in arterial phase,and NIC and k in venous phase in invasion group were higher than those in non-invasion group(P<0.05).Logistic regression analysis showed that pleural indentation,NIC in arterial phase and NIC in venous phase were risk factors for pathological aggerssive-ness in lung adenocarcinoma patients(P<0.05).ROC curve analysis showed that the combination of NIC in arterial phase and NIC in venous phase had higher value in predicting the pathological aggressiveness of lung adenocarcinoma(P<0.05).Conclusion The combination of NIC and k in venous phase is effective in the diagnosis of lung adenocarcinoma,while NIC in arterial phase and NIC in venous phase have high predictive values for the aggressiveness of lung adenocarcinoma.

OBJECTIVE To investigate the current status of contamination with carbapenem-resistant gram-negative bacteria in environment of intensive care units(ICU)of tertiary hospitals in Shanghai and find out the potential contamination sources so as to provide bases for prevention and control of multidrug-resistant organisms infec-tions in the ICUs.METHODS The surroundings of the ICU patients detected with CRGNB and environmental ob-jects surfaces in public area were sampled by mSuperCARBA chromogenic media from Dec.2024 to Jan.2025,the strains were isolated,and the targeted strains were identified by matrix-assisted laser desorption/ionization time-of-flight(MALDI-TOF)mass spectrometer.RESULTS A total of 653 samples were collected in the survey,76 of which were positive for bacterial culture,60 were detected with CRGNB,and the isolation rate of CRGNB was 9.19％.The isolation rate of CRGNB was 53.40％in the water-source group,0.91％in the non-water-source group,and there was significant difference(x2=286.450,P＜0.001).The result of whole genome sequencing for 17 strains of CRKP showed that ST11 and ST15 were the two major types of multilocus typing(MT),respective-ly carrying 2-12 types of drug resistance genes.CONCLUSIONS The CRGNB strains are detected in some environ-mental sites of the ICUs of 15 tertiary hospitals in Shanghai,and the isolation rate of CRKP is highest among them.The colonization rate of CRGNB is relatively low on the highly frequent-contact object surfaces of the ICUs,however,sink drain holes poses a risk of hospital-acquired CRGNB infections transmissions.Additionally,the ba-sins and towels of the CRGNB patients are hard to be thoroughly cleaned,disinfected and dried,resulting in a high contamination rate.

Objective To investigate the mediating effect of psychological flexibility on the relationship between pain self-efficacy and kinesiophobia in patients with lumbar disc herniation(LDH),so as to provide references for relief from kinesiophobia of the patients.Methods Convenience sampling was used to select 256 patients with LDH as the research subjects from the Outpatient Department of Spinal Orthopaedics of a Grade IIIA hospital in Guangdong Province between May and December 2023.The subjects were surveyed with a general information questionnaire,the kinesiophobia assessment scale,psychological flexibility inventory for pain patients,and chronic pain self-efficacy scale.The mediation effect of psychological flexibility on pain self-efficacy and kinesiophobia was analysed using SPSS 26.0 and the PROCESS 3.5 macro.Results The scores for kinesiophobia,psychological flexibility and pain self-efficacy among the LDH patients were 31.66±4.73,55.26±11.06 and 68.14±17.48,respectively.Kinesiophobia was positively correlated with the psychological flexibility(r=0.545,P<0.001)and negatively correlated with the pain self-efficacy(r=-0.599,P<0.001).The psychological flexibility was negatively correlated with the pain self-efficacy(r=-0.510,P<0.001).Psychological flexibility partially mediated the relationship between pain self-efficacy and kinesiophobia,with a mediating effect of-0.045,accounting for 27.78%of the total effect.Conclusion The patients who have LDH and under conservative treatment exhibit a high level of kinesiophobia and with a moderate levels of pain self-efficacy and psychological flexibility.The medical staff can improve the self-efficacy and psychological flexibility of patients,so as to reduce kinesiophobia level and its incidence.

Objective:To investigate the prevalence and influencing factors of kinesiophobia in chronic pain patients undergoing conservative treatment for lumbar disc herniation (LDH), providing reference and basis for reducing the occurrence of kinesiophobia in this patient population.Methods:A cross-sectional study was conducted from May 2023 to January 2024. A convenience sample of chronic pain patients undergoing conservative treatment for LDH in Guangdong Second Provincial General Hospital was selected as the study population. Data were collected by the general information questionnaire, Numerical Rating Scale, Tampa Scale of Kinesiophobia-11, Psychological Inflexibility in Pain Scale, and Chronic Pain Self-efficacy Scale. A random forest model was constructed to rank variable importance, and binary Logistic regression was used to analyze the influencing factors of kinesiophobia.Results:The effective response rate of the questionnaire was 96.8% (270/279). Among 270 patients, there were 139 males and 131 females, 92 patients aged 18-40 years, 132 patients aged 41-60 years, and 46 patients aged >60 years old. The total kinesiophobia score for chronic pain patients undergoing conservative treatment for LDH was (31.00 ± 5.09) points, with a kinesiophobia prevalence of 79.6% (215/270). The random forest algorithm identified eight influencing factors: pain self-efficacy, psychological flexibility, physical exercise after low back pain onset, duration of pain, pain status, understanding of LDH, marital status, and pain intensity. Binary Logistic regression analysis showed that physical exercise after low back pain onset ( OR=0.583, 95% CI 0.344-0.986), pain status ( OR=0.424, 95% CI 0.206-0.873), psychological flexibility ( OR=1.102, 95% CI 1.052-1.155), pain self-efficacy ( OR=0.923, 95% CI 0.895-0.953) were significant influencing factors of kinesiophobia in chronic pain patients undergoing conservative treatment for LDH (all P<0.05). Conclusions:The prevalence of kinesiophobia is high among chronic pain patients undergoing conservative treatment for LDH. Physical exercise after low back pain onset, pain status, psychological flexibility, and pain self-efficacy are significant influencing factors. Healthcare professionals should pay increased attention to kinesiophobia in chronic pain patients undergoing conservative treatment for LDH and implement targeted early interventions to reduce its occurrence.