Traditional Chinese medicine （TCM） diagnostics is a discipline that studies the basic theories and fundamental skills of diagnostic methods， disease diagnosis， and differentiation in accordance with the theories of TCM. The artificial intelligence （AI） technology has gained remarkable achievements in the intelligentization of the four diagnostic methods in TCM and the standardization of differentiation and diagnosis. However， it still faces many challenges. The standardization of clinical data collection is difficult， and the data quality is uneven， which affects the usability of the data. The integration of the four diagnostic information is insufficient. Most instruments can only collect data from a single diagnostic method， lacking overall integrity. The scientific nature of the diagnostic model needs to be improved. The existing models lack dynamics and the reasoning logic of TCM differentiation. The accuracy of intelligent methods needs to be improved， and the existing evaluation indicators cannot fully reflect the practical application effect of the model. Furthermore， the relevant laws and regulations are still not perfect， and data security and patient privacy lack guarantees. The cultivation of compound talents is insufficient， and there is a lack of interdisciplinary talents who are proficient in both TCM and AI. On this basis， this paper expounded on the current development status， difficulties， and bottlenecks of AI in TCM diagnosis and then explored the development trend of AI in the field of TCM diagnosis. It proposed solutions such as optimizing the data collection process， constructing multimodal diagnostic models， facilitating multi-disciplinary exchanges and cooperation， improving laws and regulations， and cultivating compound talents. It is hoped that modern， standardized， normalized， and intelligent TCM diagnosis can be further promoted， thereby providing new impetus and methods for the inheritance and innovation of TCM.

OBJECTIVE To investigate the current status of cleaning and disinfection of digestive endoscopes in vari-ous grades of hospitals of Hubei Province so as to improve the quality of cleaning and disinfection of the digestive endoscopes.METHODS A survey was conducted by the hospital infection management department of Tongji Hos-pital Affiliated to Tongji Medical College,Huazhong University of Science and Technology from Mar.25,2024 to Mar.29,2024.A questionnaire was formulated by brainstorming and literature review.The electronic question-naire was distributed through the"Wenjuanxing"platform.The questionnaire survey aimed to investigate the per-sonnel,training,equipment and facilities,cleaning and disinfection operations,monitoring and recording of the digestive endoscopy centers of the medical institutions in the province.RESULTS Totally 185 medical institutions were finally included,113 of which were tertiary hospitals,and 72 were secondary and lower-grade hospitals.The tertiary hospitals were superior to the secondary and lower-grade hospitals in the quantity of endoscopes,daily di-agnosis and treatment volume of patients,participation in external training(including continuous training,further education,hospital-level training),provision of some facilities and equipment(ultrasonic cleaners,full pipeline perfusion devices,cleaning brushes,high-pressure water guns,transport containers),some cleaning and disinfec-tion operations(changing the cleaning enzyme solution one time for one endoscope,disinfecting the cleaning brush one time after one-time use),implementation of surveillance of cleaning quality and preservation of surveil-lance records(P＜0.05).However,the tertiary hospital were inferior to the secondary and lower-grade hospitals in standardized use of transferring containers(65.49％)and drying time of air guns(57.52％)(P＜0.05).CONCLUSIONS The quality of cleaning and disinfection of the digestive endoscopes remains large room to be im-proved in the medical institutions of Hubei Province.It is necessary for the medical institutions to strengthen the supervision and training of personnel based on the their actual condition,complete the provision of facilities and e-quipment,standardize the cleaning and disinfection operations,and complete the surveillance and recordings.

OBJECTIVE To evaluate the effect of bundled property management under multidisciplinary coopera-tion mode on prevention and control of multidrug-resistant organisms(MDROs)in intensive care units(ICUs)and explore the evidence-based methods for prevention and control of MDROs.METHODS A control study before and after the same time period was designed,the post-intervention period was 2024 when the bundled measures were fully implemented,and the pre-intervention period was 2023.Totally 8 ICUs of general and special depart-ments of a three-A hospital in Hubei Province were recruited as research subjects,the multidisciplinary coopera-tion team was established,the bundled management measures were introduced to optimize the quality of property cleaning work.The quality of service of the property cleaning work was evaluated through surveillance of hospital-associated infections and environmental hygiene surveillance before and after the bundled measures were imple-mented.RESULTS The isolation rate of MDROs from object surfaces of ICU environment declined from 0.34％to 0.10％after the bundled management measures under multidisciplinary cooperation model were implemented(P＜0.05).The incidence of MDROs hospital-associated infections was reduced from 0.07％to 0.03％(P＜0.05);the isolation rate of MDROs from patients decreased from 14.68％to 12.69％(P＜0.05);the performance as-sessment score of the cleaning staff was raised from(85.56±7.21)points to(91.06±3.07)points,however,there was no significant difference.The hand hygiene compliance rate of the cleaning staff was raised from 42.86％to 68.52％(P＜0.05).The positive rate of random ATP fluorescent test for environmental object surfaces de-clined from 25.41％to 10.05％(P＜0.05).Other environmental hygiene indexes for the cleaning and disinfection effects were improved in varying degrees.CONCLUSION The bundled management measures under multidiscipli-nary cooperation mode boost the property service quality,enhance the cleaning staff's awareness of disinfection,prevention and control,reduce the isolation rate of MDROs in environment,and thus decrease the incidence of MDROs hospital-associated infections and prevent the transmission.

OBJECTIVE To explore the effect of failure mode and effect analysis(FMEA)on management of hospi-tal-associated infections(HAIs)in hemodialysis center.METHODS In Nov.2023,the risk priority number(RPN)integrated with action priority(AP)was adopted to identify,analyze and evaluate the risk factors in man-agement of HAIs in hemodialysis center of Tongji Hospital Affiliated to Tongji Medical College,Huazhong Uni-versity of Science and Technology by FMEA method.The high risk points that needed to be taken interventions were screened out,and the targeted measures were formulated to control the risks.At the end of the intervention period,a second round of risk assessment was carried out for improvement status of the high-risk points in Nov.2024,and the effect on the management of HAIs was evaluated.RESULTS The risk assessment was carried out for 48 risk points covering eight aspects,including organizational structure,self-inspection and supervision,staff management,environmental layout,cleaning and disinfection,surveillance,operation procedures and i-tem management.There were 9 risk points with the RPN values greater than 125,3 of which were with the AP value of"H".There were 8 risk points with the RPN value less than 125 and 6 risk points with the AP value drop-ping down to L after the targeted intervention measures were taken,indicating that the risk management has a-chieved favorable effect.CONCLUSIONS The RPN and AP integrated with FMEA can accurately identify the high-risk points in the quality management of the hemodialysis center.It is necessary to take targeted interven-tion measures so as to boost the effect on prevention and control of HAIs in the hemodialysis center and reduce the risk of HAIs in the hemodialysis patients.

Objective To explore the effectiveness of risk assessment in the prevention and control of central line associated-bloodstream infection(CLABSI),identify high-risk departments and processes,and develop targeted measures to reduce the risk.Methods Healthcare-associated infection control risk assessment form designed by American Association for Professionals in Infection Control and Epidemiology(APIC)was applied to assess the risk factors for CLABSI in 13 intensive care units(ICUs)in a hospital.Each risk indicator was identified,analyzed,and evaluated from three dimensions:the likelihood of risk occurrence,severity of consequences,and integrity of the current management system.Results The risk assessment results found that the general ICU and respiratory ICU had extremely high risk,cardiac surgery ICU and organ transplant ICU had high risk.Through one-year continuous intervention,the incidence of CLABSI decreased significantly,the awareness rate of CLABSI prevention and control measures and the implementation rate of partial measures increased significantly(all P＜0.05).Conclusion The application of risk assessment can screen high-risk departments,focus efforts on the intervention,and enhance the effectiveness of CLABSI risk prevention and control.

Objective To investigate the current status of job competency of full-time personnel who engaged in gastrointestinal endoscope cleaning and disinfection in medical institutions in Hubei Province,analyze the influencing factors,and provide reference for conducting the training for full-time personnel in gastrointestinal endoscope clea-ning and disinfection.Methods Through expert consultation and revision,as well as forming of questionnaire,an online survey was conducted.The questionnaire was filled out by full-time personnel who engaged in endoscope cleaning and disinfection in the endoscopy centers/rooms in medical institutions.Results A total of 195 full-time personnel engaged in cleaning and disinfecting gastrointestinal endoscopes in 185 medical institutions participated in the survey,with a self-assessment score of(4.48±0.41)point for job competency.Univariate analysis showed that there were statistically significant differences in the self-assessment scores of job competency based on different le-vels of training,training frequency,income satisfaction,and daily diagnosis and treatment volume(all P＜0.05).Multiple linear regression analysis indicated that full-time personnel with working years＞10 years,satisfying with their income,participating in provincial/national level training,receiving training at least once per year,and having an average daily diagnosis and treatment volume＞50 cases had higher self-assessment score of job competency(all P＜0.05).Conclusion In order to enhance the job competency of personnel who engage in gastrointestinal endo-scope cleaning and disinfection,it is recommended to encourage the participation in provincial/national training,and the hospital-wide training should emphasize the application and disposal of cleaning,disinfection,and storage de-vices of gastrointestinal endoscope,as well as disinfection knowledge,and encourage personnel to conduct relevant research.

OBJECTIVE To evaluate the effect of bundled property management under multidisciplinary coopera-tion mode on prevention and control of multidrug-resistant organisms(MDROs)in intensive care units(ICUs)and explore the evidence-based methods for prevention and control of MDROs.METHODS A control study before and after the same time period was designed,the post-intervention period was 2024 when the bundled measures were fully implemented,and the pre-intervention period was 2023.Totally 8 ICUs of general and special depart-ments of a three-A hospital in Hubei Province were recruited as research subjects,the multidisciplinary coopera-tion team was established,the bundled management measures were introduced to optimize the quality of property cleaning work.The quality of service of the property cleaning work was evaluated through surveillance of hospital-associated infections and environmental hygiene surveillance before and after the bundled measures were imple-mented.RESULTS The isolation rate of MDROs from object surfaces of ICU environment declined from 0.34％to 0.10％after the bundled management measures under multidisciplinary cooperation model were implemented(P＜0.05).The incidence of MDROs hospital-associated infections was reduced from 0.07％to 0.03％(P＜0.05);the isolation rate of MDROs from patients decreased from 14.68％to 12.69％(P＜0.05);the performance as-sessment score of the cleaning staff was raised from(85.56±7.21)points to(91.06±3.07)points,however,there was no significant difference.The hand hygiene compliance rate of the cleaning staff was raised from 42.86％to 68.52％(P＜0.05).The positive rate of random ATP fluorescent test for environmental object surfaces de-clined from 25.41％to 10.05％(P＜0.05).Other environmental hygiene indexes for the cleaning and disinfection effects were improved in varying degrees.CONCLUSION The bundled management measures under multidiscipli-nary cooperation mode boost the property service quality,enhance the cleaning staff's awareness of disinfection,prevention and control,reduce the isolation rate of MDROs in environment,and thus decrease the incidence of MDROs hospital-associated infections and prevent the transmission.

OBJECTIVE To investigate the current status of cleaning and disinfection of digestive endoscopes in vari-ous grades of hospitals of Hubei Province so as to improve the quality of cleaning and disinfection of the digestive endoscopes.METHODS A survey was conducted by the hospital infection management department of Tongji Hos-pital Affiliated to Tongji Medical College,Huazhong University of Science and Technology from Mar.25,2024 to Mar.29,2024.A questionnaire was formulated by brainstorming and literature review.The electronic question-naire was distributed through the"Wenjuanxing"platform.The questionnaire survey aimed to investigate the per-sonnel,training,equipment and facilities,cleaning and disinfection operations,monitoring and recording of the digestive endoscopy centers of the medical institutions in the province.RESULTS Totally 185 medical institutions were finally included,113 of which were tertiary hospitals,and 72 were secondary and lower-grade hospitals.The tertiary hospitals were superior to the secondary and lower-grade hospitals in the quantity of endoscopes,daily di-agnosis and treatment volume of patients,participation in external training(including continuous training,further education,hospital-level training),provision of some facilities and equipment(ultrasonic cleaners,full pipeline perfusion devices,cleaning brushes,high-pressure water guns,transport containers),some cleaning and disinfec-tion operations(changing the cleaning enzyme solution one time for one endoscope,disinfecting the cleaning brush one time after one-time use),implementation of surveillance of cleaning quality and preservation of surveil-lance records(P＜0.05).However,the tertiary hospital were inferior to the secondary and lower-grade hospitals in standardized use of transferring containers(65.49％)and drying time of air guns(57.52％)(P＜0.05).CONCLUSIONS The quality of cleaning and disinfection of the digestive endoscopes remains large room to be im-proved in the medical institutions of Hubei Province.It is necessary for the medical institutions to strengthen the supervision and training of personnel based on the their actual condition,complete the provision of facilities and e-quipment,standardize the cleaning and disinfection operations,and complete the surveillance and recordings.

Objective To investigate the current status of job competency of full-time personnel who engaged in gastrointestinal endoscope cleaning and disinfection in medical institutions in Hubei Province,analyze the influencing factors,and provide reference for conducting the training for full-time personnel in gastrointestinal endoscope clea-ning and disinfection.Methods Through expert consultation and revision,as well as forming of questionnaire,an online survey was conducted.The questionnaire was filled out by full-time personnel who engaged in endoscope cleaning and disinfection in the endoscopy centers/rooms in medical institutions.Results A total of 195 full-time personnel engaged in cleaning and disinfecting gastrointestinal endoscopes in 185 medical institutions participated in the survey,with a self-assessment score of(4.48±0.41)point for job competency.Univariate analysis showed that there were statistically significant differences in the self-assessment scores of job competency based on different le-vels of training,training frequency,income satisfaction,and daily diagnosis and treatment volume(all P＜0.05).Multiple linear regression analysis indicated that full-time personnel with working years＞10 years,satisfying with their income,participating in provincial/national level training,receiving training at least once per year,and having an average daily diagnosis and treatment volume＞50 cases had higher self-assessment score of job competency(all P＜0.05).Conclusion In order to enhance the job competency of personnel who engage in gastrointestinal endo-scope cleaning and disinfection,it is recommended to encourage the participation in provincial/national training,and the hospital-wide training should emphasize the application and disposal of cleaning,disinfection,and storage de-vices of gastrointestinal endoscope,as well as disinfection knowledge,and encourage personnel to conduct relevant research.

Objective To explore the effectiveness of risk assessment in the prevention and control of central line associated-bloodstream infection(CLABSI),identify high-risk departments and processes,and develop targeted measures to reduce the risk.Methods Healthcare-associated infection control risk assessment form designed by American Association for Professionals in Infection Control and Epidemiology(APIC)was applied to assess the risk factors for CLABSI in 13 intensive care units(ICUs)in a hospital.Each risk indicator was identified,analyzed,and evaluated from three dimensions:the likelihood of risk occurrence,severity of consequences,and integrity of the current management system.Results The risk assessment results found that the general ICU and respiratory ICU had extremely high risk,cardiac surgery ICU and organ transplant ICU had high risk.Through one-year continuous intervention,the incidence of CLABSI decreased significantly,the awareness rate of CLABSI prevention and control measures and the implementation rate of partial measures increased significantly(all P＜0.05).Conclusion The application of risk assessment can screen high-risk departments,focus efforts on the intervention,and enhance the effectiveness of CLABSI risk prevention and control.