ObjectiveTo assess the risk of vector-born infectious diseases by monitoring the major vectors in the relevant venues of the 19th Hangzhou Asian Games in Fuyang competition area, so as to provide references for the prevention and control of vector in similar large-scale events or activities in the future. MethodsFrom April to October 2023, monitoring and evaluation of rodent, mosquito, fly and cockroach density levels were carried out in various venues and reception hotels in Fuyang competition area (venues and hotels were the 1st circle area, and various environments and places in the surrounding 500 meters were the 2nd circle area). SPSS 25.0 software was used to analyze the data, and chi-square test or Fisher’s precision probability test were used to calculate the qualified rate and positive rate. Moreover, the path index, landing index and Bretrau index were analyzed by Kruskal-Wallis H test. ResultsThe control effect of vector density in the 1st circle was significantly better than that in the 2nd circle. Since September, the monitoring indices of the venues in the two circles had reached the national A-level and B-level standard, respectively. The positive rate of rodent traces generally showed a trend of first increasing and then decreasing, and the peak was shown to occur in July and August, with the highest rate of 5.38%. The qualified rate of rodent prevention facilities continued to rise, and facilities in the 1st and 2nd circles had reached national A-level and B-level standard respectively in late August. The landing index and path index of mosquitoes basically showed a changing trend from high to low, with the highest landing index of 4.56 individuals·person-time^-1 and the highest path index of 2.44 places·km^-1.The adult fly infestation rate remained at a low level, with the highest rate of 4.17%, and the minimum qualified rate of fly prevention facilities was 28.57%, which reached the national standard after July. The positive detection rates of adult flies and cockroach traces showed no significant pattern, with the highest rate of 7.00% and 8.33%, respectively. The detection rate of live ootheca was always at a low level. ConclusionThe relevant venues in the Fuyang competition area of the 19th Asian Games in Hangzhou meet national standards in terms of vector control indicators such as rodents, mosquitoes, flies, cockroaches and other vectors. By means of environmental improvement, facilities for preventing rodents and flies, and deepening biological and chemical prevention and control methods, it can be ensured that there will be no vector-borne diseases and infestation incidents during the event.

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.

Adenoviruses are the main pathogens causing acute respiratory tract infection in infants and young children,and adenovirus types 3 and 7 infections often develop into severe pneumonia,which seriously threatens chil-dren's health and affects their quality of life.Exosomes are extracellular vesicles that possess a phospholipid bilayer struc-ture.Exosomes can be secreted and synthesized by various cells and can carry a variety of bioactive substances,such as nucleic acids and proteins.The occurrence and release of exosomes are closely related to the physiological functions of the body's cells.In recent years,studies have shown that exosomes released by patients with adenovirus infection play crucial roles in transmission and immune response activation against the virus.Therefore,in-depth research on exosomes and ade-noviruses provides new directions for the diagnosis,treatment,and clinical drug development of paediatric adenovirus pneumonia.

Adenoviruses are the main pathogens causing acute respiratory tract infection in infants and young children,and adenovirus types 3 and 7 infections often develop into severe pneumonia,which seriously threatens chil-dren's health and affects their quality of life.Exosomes are extracellular vesicles that possess a phospholipid bilayer struc-ture.Exosomes can be secreted and synthesized by various cells and can carry a variety of bioactive substances,such as nucleic acids and proteins.The occurrence and release of exosomes are closely related to the physiological functions of the body's cells.In recent years,studies have shown that exosomes released by patients with adenovirus infection play crucial roles in transmission and immune response activation against the virus.Therefore,in-depth research on exosomes and ade-noviruses provides new directions for the diagnosis,treatment,and clinical drug development of paediatric adenovirus pneumonia.

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.

Critically ill patients are at high risk for hospital acquired infections, which can significantly increase the mortality rate and treatment costs for these patients. Therefore, in the process of treating the primary disease, strict prevention and control of new hospital infections is an essential component of the treatment for critically ill patients. The treatment of critically ill patients involves multiple steps and requires a concerted effort from various aspects such as theory, management, education, standards, and supervision to achieve effective prevention and control of hospital infections. However, there is currently a lack of unified understanding and standards for hospital infection prevention and control. To address this, in March 2024, a group of experts in critical care medicine, infectious diseases, and hospital infection from China discussed the current situation and issues of hospital infection control in the intensive care unit together. Based on a review of the latest evidence-based medical evidence from both domestic and international sources, 2024 Expert Consensus on Hospital Acquired Infection Control Principles in the Department of Critical Care Medicine was formed, aiming to provide a basis for the development of hospital infection prevention and control strategies in the field of critical care medicine.

Objective A simplified pelvic model of a patient was established,and periacetabular osteotomy(PAO)was simulated to investigate its effects on the stress in the sacroiliac joints in the standing position.Methods The anterior center edge angle(ACEA)and lateral center edge angle(LCEA)of the patient's hip model were adjusted,and 27 postoperative models were obtained.Finite element calculations and analyses of each model were performed during single-leg standing and double-leg standing.Furthermore,an investigation of the stress variations and distributions on the sacroiliac cartilage was conducted in combination with a hip joint stress analysis.Results During single-leg standing,the maximum stress on the sacroiliac cartilage of a healthy individual was 18.2 MPa.With an increase in the anterior center edge angle(ACEA),the von Mises stress of the sacroiliac cartilage decreased from 34.5 MPa to 19.8 MPa.The maximum von Mises stress in the acetabular cartilage decreased from 4.767 MPa to 2.7 MPa.Before the ACEA attained 36°,the maximum von Mises stress exhibited a downward trend.After it attained 36°,the stress distribution began to increase,and the stress distribution improved significantly.During double-leg standing,the minimum and maximum von Mises stresses on the sacroiliac cartilage of the affected leg side were 2.8 and 6.5 MPa,respectively.The sacroiliac cartilage stress on the normal leg side did not vary significantly,and the stress difference between the two leg sides decreased gradually.Conclusions PAO can improve the hip joint stress and sacroiliac joint stress.Additionally,the improvement of sacroiliac joint stress is identical to that of hip joint stress.Prior to surgery,a comprehensive planning of the hip and sacroiliac joints can be used as a reference by doctors.This is of high significance for patients with developmental dysplasia of the hip(DDH)to achieve better outcomes.

Objective A simplified pelvic model of a patient was established,and periacetabular osteotomy(PAO)was simulated to investigate its effects on the stress in the sacroiliac joints in the standing position.Methods The anterior center edge angle(ACEA)and lateral center edge angle(LCEA)of the patient's hip model were adjusted,and 27 postoperative models were obtained.Finite element calculations and analyses of each model were performed during single-leg standing and double-leg standing.Furthermore,an investigation of the stress variations and distributions on the sacroiliac cartilage was conducted in combination with a hip joint stress analysis.Results During single-leg standing,the maximum stress on the sacroiliac cartilage of a healthy individual was 18.2 MPa.With an increase in the anterior center edge angle(ACEA),the von Mises stress of the sacroiliac cartilage decreased from 34.5 MPa to 19.8 MPa.The maximum von Mises stress in the acetabular cartilage decreased from 4.767 MPa to 2.7 MPa.Before the ACEA attained 36°,the maximum von Mises stress exhibited a downward trend.After it attained 36°,the stress distribution began to increase,and the stress distribution improved significantly.During double-leg standing,the minimum and maximum von Mises stresses on the sacroiliac cartilage of the affected leg side were 2.8 and 6.5 MPa,respectively.The sacroiliac cartilage stress on the normal leg side did not vary significantly,and the stress difference between the two leg sides decreased gradually.Conclusions PAO can improve the hip joint stress and sacroiliac joint stress.Additionally,the improvement of sacroiliac joint stress is identical to that of hip joint stress.Prior to surgery,a comprehensive planning of the hip and sacroiliac joints can be used as a reference by doctors.This is of high significance for patients with developmental dysplasia of the hip(DDH)to achieve better outcomes.

Objective:To construct preliminarily the malignant risk classification system for the cervical lymph node.Methods:A total of 301 patients with cervical lymphadenopathy were collected in this prospective study from Union Hospital, Fujian Medical University from July 2018 to December 2019. The ultrasonographic features(including the short diameter, ratio of long to short diameters(L/S), margin, border, matting, echogenic hilum, echogenicity, gross necrosis, microcalcification, hyperechoic area, flow type, vascular distribution), history of malignancy, inflammation performance of the neck and history of tuberculosis were analyzed. A score was assigned for each significant index related to benign/malignant lymph nodes by a Logistic regression analysis. The classification of the malignant risk was determined on the basis of the scores.Results:The factors significantly associated with the malignant lymph nodes were enlargement of the short diameter, L/S<2, microcalcification, hyperechoic area, irregular margin, matting, abnormal flow pattern, malignancy history. While the factors related to the benign were the inflammation performance and the fuzzy boundary. The risk of malignancy increased as the score of lymph node increased. The malignant risk of lymph node according to the classification system was as follows: category 1, 7.30%; category 2a, 35.00%; category 2b, 69.30%; category 2c, 91.50%; and category 3, 99.05%. The area under the ROC curve of the system was 0.913.Conclusions:The system has great potential of clinical application to assess the risk of malignancy in cervical lymph nodes.

To establish the experts consensus on the management of delirium in critically ill patients.A special committee was set up by 15 experts from the Chinese Critical Hypothermia-Sedation Therapy Study Group.Each statement was assessed based on the GRADE (Grading of Recommendations Assessment,Development,and Evaluation) principle.Then the Delphi method was adopted by 36 experts to reassess all the statements.(1) Delirium is not only a mental change,but also a clinical syndrome with multiple pathophysiological changes.(2) Delirium is a form of disturbance of consciousness and a manifestation of abnormal brain function.(3) Pain is a common cause of delirium in critically ill patients.Analgesia can reduce the occurrence and development of delirium.(4) Anxiety or depression are important factors for delirium in critically ill patients.(5) The correlation between sedative and analgesic drugs and delirium is uncertain.(6) Pay attention to the relationship between delirium and withdrawal reactions.(7) Pay attention to the relationship between delirium and drug dependence/ withdrawal reactions.(8) Sleep disruption can induce delirium.(9) We should be vigilant against potential risk factors for persistent or recurrent delirium.(10) Critically illness related delirium can affect the diagnosis and treatment of primary diseases,and can also be alleviated with the improvement of primary diseases.(11) Acute change of consciousness and attention deficit are necessary for delirium diagnosis.(12) The combined assessment of confusion assessment method for the intensive care unit and intensive care delirium screening checklist can improve the sensitivity of delirium,especially subclinical delirium.(13) Early identification and intervention of subclinical delirium can reduce its risk of clinical delirium.(14) Daily assessment is helpful for early detection of delirium.(15) Hopoactive delirium and mixed delirium are common and should be emphasized.(16) Delirium may be accompanied by changes in electroencephalogram.Bedside electroencephalogram monitoring should be used in the ICU if conditions warrant.(17) Pay attention to differential diagnosis of delirium and dementia/depression.(18) Pay attention to the role of rapid delirium screening method in delirium management.(19) Assessment of the severity of delirium is an essential part of the diagnosis of delirium.(20) The key to the management of delirium is etiological treatment.(21) Improving environmental factors and making patient comfort can help reduce delirium.(22) Early exercise can reduce the incidence of delirium and shorten the duration of delirium.(23) Communication with patients should be emphasized and strengthened.Family members participation can help reduce the incidence of delirium and promote the recovery of delirium.(24) Pay attention to the role of sleep management in the prevention and treatment of delirium.(25) Dexmedetomidine can shorten the duration of hyperactive delirium or prevent delirium.(26) When using antipsychotics to treat delirium,we should be alert to its effect on the heart rhythm.(27) Delirium management should pay attention to brain functional exercise.(28) Compared with non-critically illness related delirium,the relief of critically illness related delirium will not accomplished at one stroke.(29) Multiple management strategies such as ABCDEF,eCASH and ESCAPE are helpful to prevent and treat delirium and improve the prognosis of critically ill patients.(30) Shortening the duration of delirium can reduce the occurrence of long-term cognitive impairment.(31) Multidisciplinary cooperation and continuous quality improvement can improve delirium management.Consensus can promote delirium management in critically ill patients,optimize analgesia and sedation therapy,and even affect prognosis.