OBJECTIVE To investigate the direct economic losses caused by surgical site infection(SSI)in patients undergoing orthopedic surgery and provide references for medical institutions to develop infection prevention and control measures.METHODS Clinical data of 8 207 patients undergoing orthopedic surgery from the People's Hospital of Sanshui District,Foshan City,between 2021 and 2023 were retrospectively collected.Among them,98 patients with SSI were assigned to the SSI group,while non-infected patients were included in the non-infection group.Based on a 1∶1 matched case-control principle,68 well-matched pairs of case-control samples were select-ed for comparative analysis.Key indicators such as hospitalization costs and postoperative hospital stays were de-scribed as medians,and intergroup differences were analyzed with the Wilcoxon signed-rank test.RESULTS The SSI incidence rate was 1.19％(98/8 207).Compared to non-infected patients,those with SSI had an average pro-longed postoperative hospital stay of 13.95 days,with an average direct economic loss of RMB 14 305.50 yuan per case.Direct economic losses due to SSI varied among patients with different surgical sites,age groups and wheth-er medical devices were implanted.There were statistically significant differences in the increased hospitalization costs and postoperative hospital stays between the SSI group and the non-infected group(P＜0.05).CONCLUSIONS SSI in patients undergoing orthopedic surgery leads to increased hospitalization costs,prolonged postoperative hospital stays and greater direct economic losses.Therefore,medical institutions should implement a series of efficient and targeted prevention and control measures to effectively reduce SSI incidence rate,there-by improve medical quality and patient safety.

Objective To construct a quality control model for cervical liquid-based thin cell smears using two different artificial intelligence(AI)techniques and to compare the total use of the two methods to improve the level of quality control of cervical liquid-based thin cell smears through the assistance of hybrid AI.Methods In this study,105 cervical liquid-based thin cell smear samples were used.Convolutional neural network(CNN)algorithm and Transformer network algorithm were used as specific AI algorithms in the AI model.The labeled features included the number of cells in the slice,excessive red blood cells,excessive inflammatory cells,and air bubbles.The smear samples were pre-processed and digitized by smear,followed by image segmentation and feature extraction.Using the labeled feature data,machine learning models were trained and optimized.Statistical AI and physician QC results were analyzed by calculating KAPPA index,sensitivity,specificity,area under the curve(AUC),and other indexes for AI QC results.Results CNN algorithm QC results in normal smear,inflammatory background and bloody background were significantly different from the expert review QC results(P＜0.001).Transformer algorithm QC results were similar to the expert review results,with no statistical difference(P＞0.05).General practitioner QC results were statistically different from the expert review QC results in normal smear detection rate and bloody background(P＜0.001).CNN algorithm Kappa value was 0.567,which had medium consistency with expert review results.Transformer algorithm Kappa value was 0.890,with the best consistency with expert review results.General practitioner Kappa value was 0.675,which had better consistency with expert review results.Using the expert review results as a reference standard,the predictive efficacy of the Transformer algorithm and the general practitioners' QC results was evaluated,and the predictive efficacy of the Transformer algorithm was higher than that of the general practitioners in detecting hemorrhagic backgrounds and normal smears(inflammatory backgrounds:AUC=1.000;normal smears:AUC=0.768)(hemorrhagic backgrounds:AUC=0.849;normal smears:AUC=0.849;normal smear:AUC=0.500).Conclusion In this study,we found that the Transformer algorithm was effective in improving the quality control of cervical liquid-based thin-layer cell smears by assisting doctors to perform smear quality control scoring and improving the efficiency and accuracy of smear sample quality control.It can be used as a new quality control method for cervical cancer cytological screening and has potential clinical applications.

Objective To construct a quality control model for cervical liquid-based thin cell smears using two different artificial intelligence(AI)techniques and to compare the total use of the two methods to improve the level of quality control of cervical liquid-based thin cell smears through the assistance of hybrid AI.Methods In this study,105 cervical liquid-based thin cell smear samples were used.Convolutional neural network(CNN)algorithm and Transformer network algorithm were used as specific AI algorithms in the AI model.The labeled features included the number of cells in the slice,excessive red blood cells,excessive inflammatory cells,and air bubbles.The smear samples were pre-processed and digitized by smear,followed by image segmentation and feature extraction.Using the labeled feature data,machine learning models were trained and optimized.Statistical AI and physician QC results were analyzed by calculating KAPPA index,sensitivity,specificity,area under the curve(AUC),and other indexes for AI QC results.Results CNN algorithm QC results in normal smear,inflammatory background and bloody background were significantly different from the expert review QC results(P＜0.001).Transformer algorithm QC results were similar to the expert review results,with no statistical difference(P＞0.05).General practitioner QC results were statistically different from the expert review QC results in normal smear detection rate and bloody background(P＜0.001).CNN algorithm Kappa value was 0.567,which had medium consistency with expert review results.Transformer algorithm Kappa value was 0.890,with the best consistency with expert review results.General practitioner Kappa value was 0.675,which had better consistency with expert review results.Using the expert review results as a reference standard,the predictive efficacy of the Transformer algorithm and the general practitioners' QC results was evaluated,and the predictive efficacy of the Transformer algorithm was higher than that of the general practitioners in detecting hemorrhagic backgrounds and normal smears(inflammatory backgrounds:AUC=1.000;normal smears:AUC=0.768)(hemorrhagic backgrounds:AUC=0.849;normal smears:AUC=0.849;normal smear:AUC=0.500).Conclusion In this study,we found that the Transformer algorithm was effective in improving the quality control of cervical liquid-based thin-layer cell smears by assisting doctors to perform smear quality control scoring and improving the efficiency and accuracy of smear sample quality control.It can be used as a new quality control method for cervical cancer cytological screening and has potential clinical applications.

OBJECTIVE To investigate the direct economic losses caused by surgical site infection(SSI)in patients undergoing orthopedic surgery and provide references for medical institutions to develop infection prevention and control measures.METHODS Clinical data of 8 207 patients undergoing orthopedic surgery from the People's Hospital of Sanshui District,Foshan City,between 2021 and 2023 were retrospectively collected.Among them,98 patients with SSI were assigned to the SSI group,while non-infected patients were included in the non-infection group.Based on a 1∶1 matched case-control principle,68 well-matched pairs of case-control samples were select-ed for comparative analysis.Key indicators such as hospitalization costs and postoperative hospital stays were de-scribed as medians,and intergroup differences were analyzed with the Wilcoxon signed-rank test.RESULTS The SSI incidence rate was 1.19％(98/8 207).Compared to non-infected patients,those with SSI had an average pro-longed postoperative hospital stay of 13.95 days,with an average direct economic loss of RMB 14 305.50 yuan per case.Direct economic losses due to SSI varied among patients with different surgical sites,age groups and wheth-er medical devices were implanted.There were statistically significant differences in the increased hospitalization costs and postoperative hospital stays between the SSI group and the non-infected group(P＜0.05).CONCLUSIONS SSI in patients undergoing orthopedic surgery leads to increased hospitalization costs,prolonged postoperative hospital stays and greater direct economic losses.Therefore,medical institutions should implement a series of efficient and targeted prevention and control measures to effectively reduce SSI incidence rate,there-by improve medical quality and patient safety.

Objective:To study the efficacy and safety of CT guided percutaneous transhepatic microwave ablation (PTPMWA) for primary liver cancer (PLC) in liver segment 9.Methods:A retrospective study was conducted on PLC patients between October 2013 and March 2019 at Dongguan People’s Hospital, Southern Medical University. Of 41 patients who entered into the study, there were 36 males and 5 females, with an average age of 59.1 years. These patients were diagnosed to have PLC in segment 9. The surgical related data and follow-up results were collected and analyzed.Results:All patients enrolled in the study completed the treatment procedure. CT scan was performed immediately after ablation which showed that the tumor areas to be completely covered by ablation. The duration of operation ranged from 45 to 260 (mean 91) min. The amount of bleeding during treatment was 1.0 to 5.0 (mean 1.4) ml. The complete response rate was 97.6% (40 patients) and the partial response rate was 2.4% (1 patient). The cumulative survival rates at 1, 2, 3, 4 and 5 years were 95.1%, 85.4%, 75.3%, 45.2% and 45.2%, respectively. Only 4 patients (9.8%) developed recurrence after treatment. The timings of recurrence were 1, 6, 13 and 67 months after treatment, respectively. The recurrent lesions were ablated again and complete response was obtained in all patients. There were no serious problems related to complications from ablation. The rate of postoperative complication was 7.3% (3 patients).Conclusion:PTPMWA is a novel treatment for patients with PLC in liver segment 9, the advantages of this treatment include good safety, high efficacy, low complications and local recurrence. The treatment is worthy of further future studies.

AIM: To explored the potential role of HIF-1α in reducing the neuronal apoptosis and promoting the neuronal proliferation after stroke in rats. METHODS: The bone marrow-derived mesenchymal stem cells (BMSCs) were lentivirally transduced to express the stable form of HIF-1α. Ischemic stroke was induced by permanent middle cerebral artery occlusion (MCAO) in Sprague-Dawley rats. Neurological function was evaluated by modified neurological severity score (mNSS). Cerebral infarct volume was measured by TTC staining. Immunohistochemistry and terminal deoxynucleotidyltransferase mediated dUTP nick end labeling (TUNEL) method were performed to detect neuronal proliferation and apoptosis. RESULTS: Significant improvement of neurological deficits was found in BMSCs-mHIF-1α rats as compared to the control animals at 14th d and 28th d after MCAO (P<0.05). Significant reduction of infarct volume was observed in rats in BMSCs-mHIF-1α group at 3rd day after MCAO (P<0.05). Histological evaluation showed that BMSCs-mHIF-1α treatment significantly promoted neuronal survival and proliferation in the ischemic boundary area. CONCLUSION: Constitutive expression of HIF-1α in BMSCs reduces the neuronal apoptosis and promotes the neuronal proliferation after stroke in rats.

[Objective] To investigate the effects of preconditioning with low concentration of hydrogen peroxide (H2O2) on oxidative stress-induced BMSC apoptosis.[Methods] In vitro separation,purification,culture,and amplification of bone marrow mesenchymal stem cells were performed.BMSC were insulted with 0,50,100,200,300,400,500 μmol/L H2O2 and the effect of different consentration of H2O2 on BMSC was detected by Flow cytometry (FCM).And then cells were preconditioned with different consentraion of H2O2.(FCM) was used to determine the protective role of H2O2 preconditioning on BMSC apoptosis,BMSC chromatin distribution changes were observed by Hoechst33324;BMSC Caspase-3 and Bcl-2 gene changes were detected by RT-PCR.[Results] Analysis of BMSC apoptosis by flow cytometry showed that H2O2 induced BMSC apoptosis in a dose-dependent manner,and pretreatment of the cells with low concentration of H2O2 prevented subsequent stimulation with high H2O2.RT-PCR results showed that preconditioning with low concentration of H2O2 reduced the BMSC Caspase-3 gene expression but increased Bcl-2 gene expression.[Conclusion] Preconditioning with low concentration of H2O2 has an adaptive role in BMSC,and its mechanism may be related to inhibit abnormal gene expression of Caspase-3 and increase the gene expression of Bcl-2.

AIM:To investigate the role of SDF-1? in migrating of bone marrow stromal cells to the injured areas. METHODS:Ischemic brain lesion model was created in rats by permanent middle cerebral artery occlusion (MCAO). 48 SD rats were divided randomly into 2 groups. Group 1:phosphate buffered saline (PBS 1 mL) for control (n=25); Group 2:BMSCs (2?106) were injected intravenously at 24 h after MCAO (n=24). After propagated in BMSCs,Ad5/F35 GFP (green fluorescent protein) was infected to BMSCs. The expression of SDF-1? (stromal cell-derived factor-1?) mRNA in the penrumbral tissue was assayed by real-time quantitative PCR. The expression of CXCR4 on MSCs was detected by flow cytometry. Confocal microscopy was used to detect the GFP-labeled MSCs migration. RESULTS:Ad5/F35 GFP signals was observed in almost infected BMSCs. The expressions of SDF-1? mRNA in the thalamus and hippocampus of the ischemic brains were peaked at 3rd day after stroke,followed by a decrease at 14th day post-ischemia. The expression of SDF-1? mRNA in the cortex of the ischemic brains was peaked at 7th day post-ischemia,still at high level at 14th day post-ischemia. The median percentage of surface CXCR4 expression in BMSCs was 14%. GFP labeled BMSCs were detected in the origination of the middle cerebral artery (olfactory area) at 6 h,after 3 days in the prenumbra tissue such as thalamus,and in the cortex more labeled cells were found after 14 d post-ischemia.CONCLUSION:BMSCs can pass through the blood brain barrier of ischemic rats. Its mechanism might be associated with the expression of SDF-1? in the ischemic brain.

AIM:To explored the potential role of HIF-1? in reducing the neuronal apoptosis and promoting the neuronal proliferation after stroke in rats. METHODS:The bone marrow-derived mesenchymal stem cells (BMSCs) were lentivirally transduced to express the stable form of HIF-1?. Ischemic stroke was induced by permanent middle cerebral artery occlusion (MCAO) in Sprague-Dawley rats. Neurological function was evaluated by modified neurological severity score (mNSS). Cerebral infarct volume was measured by TTC staining. Immunohistochemistry and terminal deoxynucleotidyltransferase mediated dUTP nick end labeling (TUNEL) method were performed to detect neuronal proliferation and apoptosis. RESULTS:Significant improvement of neurological deficits was found in BMSCs-mHIF-1? rats as compared to the control animals at 14th d and 28th d after MCAO (P