Objective:To develop a quality assessment index system for infection prevention and control in integrated medical and elderly care facilities, providing methods for assessing infection control quality and a theoretical basis for enhancing infection prevention and control capabilities.Methods:This study initially constructed a framework for the quality evaluation index system through literature reviews, work specifications and standards and expert interviews. The Delphi method was employed to conduct two rounds of consultations with 19 experts to evaluate the necessity, feasibility, stability, and sensitivity of the indicators. The expert′s active coefficient, authority coefficient, degree of consensus, and coordination were statistically analyzed. The indicators were revised based on expert opinions to finalize the evaluation index system. The weights of the evaluation dimensions were determined using the Analytic Hierarchy Process (AHP), while the weights of the indicators were determined using the proportional allocation method. Reliability was assessed via Cronbach′s α coefficient, and content validity was verified through the Content Validity Index ( CVI). Results:After two rounds of expert consultation, the expert positive coefficient, expert authority coefficient ( Cr) and expert coordination coefficient Kendall′s W was 100%, 0.992 and 0.634 ( P<0.001), indicating high expert authority, good concentration and coordination of opinions. The assessment index system for infection prevention and control quality in integrated medical and elderly care facilities was ultimately constructed, comprising three primary indicators, 18 secondary indicators and 68 tertiary indicators. Among the primary indicators, the process quality had the highest weight of 0.338. Within the process quality, the secondary indicators with the highest weights were infection control material allocation, hand hygiene quality and the management of cluster outbreaks. A total of 11 unique evaluation indicators for integrated medical and elderly care facilities were established, with the highest weighted indicator being the rate of standardized surveillance of infection-related risk factors. Reliability and validity analyses demonstrated that the overall Cronbach′s α coefficient of the system was 0.991, and the Scale-level Content Validity Index was 0.936, confirming good reliability and validity. Conclusion:The evaluation index system constructed in this study can serve as an effective assessment tool for the quantitative evaluation of infection control quality in integrated medical and elderly care facilities. Furthermore, it is recommended that the system undergo continuous optimization concerning its application.

Objective:To develop a quality assessment index system for infection prevention and control in integrated medical and elderly care facilities, providing methods for assessing infection control quality and a theoretical basis for enhancing infection prevention and control capabilities.Methods:This study initially constructed a framework for the quality evaluation index system through literature reviews, work specifications and standards and expert interviews. The Delphi method was employed to conduct two rounds of consultations with 19 experts to evaluate the necessity, feasibility, stability, and sensitivity of the indicators. The expert′s active coefficient, authority coefficient, degree of consensus, and coordination were statistically analyzed. The indicators were revised based on expert opinions to finalize the evaluation index system. The weights of the evaluation dimensions were determined using the Analytic Hierarchy Process (AHP), while the weights of the indicators were determined using the proportional allocation method. Reliability was assessed via Cronbach′s α coefficient, and content validity was verified through the Content Validity Index ( CVI). Results:After two rounds of expert consultation, the expert positive coefficient, expert authority coefficient ( Cr) and expert coordination coefficient Kendall′s W was 100%, 0.992 and 0.634 ( P<0.001), indicating high expert authority, good concentration and coordination of opinions. The assessment index system for infection prevention and control quality in integrated medical and elderly care facilities was ultimately constructed, comprising three primary indicators, 18 secondary indicators and 68 tertiary indicators. Among the primary indicators, the process quality had the highest weight of 0.338. Within the process quality, the secondary indicators with the highest weights were infection control material allocation, hand hygiene quality and the management of cluster outbreaks. A total of 11 unique evaluation indicators for integrated medical and elderly care facilities were established, with the highest weighted indicator being the rate of standardized surveillance of infection-related risk factors. Reliability and validity analyses demonstrated that the overall Cronbach′s α coefficient of the system was 0.991, and the Scale-level Content Validity Index was 0.936, confirming good reliability and validity. Conclusion:The evaluation index system constructed in this study can serve as an effective assessment tool for the quantitative evaluation of infection control quality in integrated medical and elderly care facilities. Furthermore, it is recommended that the system undergo continuous optimization concerning its application.

Objective:To investigate the predictive values of baseline hematoma mean CT value and shape regularity (SR) for hematoma enlargement (HE) in patients with spontaneous intracerebral hemorrhage (ICH).Methods:Patients with ICH admitted to Yulin First Hospital from June 2018 to December 2021 were retrospectively included. The first head CT scan was performed within 24 h of onset, and the second head CT scan was performed within 72 h of the first scan. HE was defined as an increase in hematoma volume of at least 6 ml or 33% from the first CT. 3D Slicer software was used to reconstruct 3D images and SR was calculated. Multivariate logistic regression analysis was used to determine the independent factor for HE. Receiver operator characteristic (ROC) curve was used to evaluate the predictive value of baseline hematoma mean CT value for HE. Results:A total of 249 patients with ICH were enrolled, including 134 males (53.8%), and aged 62.2±12.1 years. The median baseline Glasgow Coma Scale score was 12, and the median time from onset to first CT scan was 3.1 h. The median baseline hematoma volume was 10.9 ml, and 58 patients (23.3%) showed HE. The baseline hematoma mean CT value in the HE group (58.5±3.2 HU vs. 60.3±3.3 HU; P<0.01) and baseline SR (0.615±0.146 vs. 0.688±0.100; P<0.001) were significantly lower in the non-HE group. Multivariate logistic regression analysis showed that the time from onset to first CT scan (odds ratio [ OR] 0.867, 95% confidence interval [ CI] 0.786-0.957; P=0.004), the baseline hematoma volume ( OR 1.050, 95% CI 1.028-1.073; P<0.001), and the baseline hematoma mean CT value ( OR 0.809, 95% CI 0.725-0.902; P<0.001) were the independent predictors of HE, while the baseline SR had no significant independent correlation with HE. ROC curve analysis showed that the area under the curve of baseline hematoma mean CT value for predicting HE was 0.652 (95% CI 0.573-0.731; P<0.001), with an optimal cutoff value of 57.97 HU. The sensitivity and specificity for predicting HE were 50% and 75.9%, respectively. Conclusion:The baseline hematoma mean CT value is an independent factor for HE in patients with ICH and has certain predictive value for HE.

Objective: To understand the knowledge of disinfection and its influencing factors among caregivers in childcare centers in Huangpu District, Shanghai, in order to provide a basis for the future development of targeted training programs and the work plan to enhance the professional level of disinfection practitioners in childcare centers. Methods: A total of 423 caregivers from 62 childcare centers (including nursery schools) in Huangpu District were selected for a questionnaire about disinfection knowledge, influencing factors, and training needs in March 2023. Differences in disinfection knowledge among subjects with different characteristics were compared using χ 2 tests, and influencing factors were analyzed using a multi factor binary Logistic regression model. Results: The overall knowledge rate of disinfection among caregivers was 50.12%, and those in public kindergartens, private ones, and nursery schools were 51.35%, 46.18%, and 42.57%, respectively, with statistically significant differences ( χ 2=14.25, P < 0.05 ). The caregivers in the highest level kindergartens ( OR =4.50, 95% CI =1.97-10.29), in first level ones ( OR =4.29, 95% CI = 1.98-9.33), in the institutions had clusters of outbreaks ( OR =1.87, 95% CI =1.14-3.07), in which the number of children to caregivers ratio being less than 10∶1 ( OR =21.81, 95% CI =2.55-186.59), with 6-14 years of working experience ( OR =3.51, 95% CI = 1.59 -7.75) had better knowledge of disinfection( P <0.05). Conclusions Knowledge of disinfection among caregivers of childcare institutions is low in Huangpu District, Shanghai. Training of caregivers disinfection knowledge should be strengthened for caregivers with fewer years of experience, in childcare institutions, to improve caregivers disinfection expertise and skills.

Compelling evidence has demonstrated the critical role of circular RNAs (circRNAs) during lung adenocarcinoma (LUAD) progression. Herein, we explored a novel circRNA, circ_0129047, and detailed its mechanism of action. The expression of circ 0129047, microRNA-665 (miR-665), and protein tyrosine phosphatase receptor type B (PTPRB) in LUAD tissues and cells was determined using reverse transcription quantitative polymerase chain reaction and Western blotting. Cell Counting Kit-8 and colony formation assays were conducted to detect LUAD cell proliferation, and western blotting was performed to quantify apoptosis-related proteins (Bcl-2 and Bax). Luciferase reporter and RNA immunoprecipitation assays were used to validate the predicted interaction between miR-665 and circ_0129047 or PTPRB.A xenograft assay was used for the in vivo experiments. Circ_0129047 and PTPRB were downregulated in LUAD tissues and cells, whereas miR-665 expression was upregulated. Overexpression of circ_0129047 suppresses LUAD growth in vivo and in vitro. Circ_0129047 is the target of miR-665, and the miR-665 mimic ablated the antiproliferative and pro-apoptotic phenotypes of LUAD cells by circ_0129047 augmentation. MiR-665 targets the 3ʹUTR of PTPRB and downregulates PTPRB expression. PTPRB overexpression offsets the pro-proliferative potential of miR-665 in LUAD cells. Circ_0129047 sequestered miR-665 and upregulated PTPRB expression, thereby reducing LUAD progression, suggesting a promising approach for preventing LUAD.

ObjectiveTo investigate the quality of disinfection in the SARS-CoV-2 nucleic acid sampling sites in Shanghai. MethodsSwab samples of medical staff’ hands and environments of different SARS-CoV-2 nucleic acid sampling sites were collected from July to September 2022， with the total number of bacterial colonies cultured and counted. ResultsA total of 728 swab samples were collected from 69 sampling sites. The median total number of bacterial colonies on hand surface， object surface and air samples were 0 CFU·cm^-2， 0 CFU·cm^-2， and1 CFU·（petri dish∙5 min）^-1， respectively， and P₉₅ was 13 CFU·cm^-2， 5.3 CFU·cm^-2， and 17.8 CFU·（culture vessel∙5 min）^-1， respectively. According to the GB 15982‒2012 Hygienic Standard for Disinfection in Hospitals class Ⅳ environment， 680 samples met the standard （93.4%）. Furthermore， 96.9%， 92.0%， and 92.2% of the samples in the sampling sites of tertiary/secondary hospitals， community health centers， and community convenience sampling sites met the standard， respectively. Quality of disinfection did not differ significantly across these sampling sites. ConclusionThe quality of disinfection in the SARS-CoV-2 nucleic acid sampling sites in Shanghai is generally good. Additionally， hand hygiene of medical staff and disinfection on object surface in some sampling sites need to be strengthened.

Objective: To explore the costs and other information of two different treatment plans for pediatric acute promyelocytic leukemia (APL): one is the traditional intravenous drip arsenic (arsenic trioxide) combined with chemotherapy treatment, and the other is a medication family treatment program based on oral arsenic (Realgar-Indigo naturalis formula), in order to provide a reference for the promotion of pediatric APL family treatment mode and the formulation of medical insurance policies. Methods: The medical record homepage data and drug using of pediatric APL from 2010 to 2018 in Institute of Hematology & Blood Diseases Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College were retrospectively analyzed, and the newly diagnosed pediatric patients (≤14 years old) with APL were included. The hospitalization expenses and hospitalization time of two treatment options were compared. One treatment option was Chinese children APL treatment plan 2010 (CCAPL 2010), which was based on intravenous drip arsenic trioxide. The other was Chinese Children Cancer Group APL treatment plan 2017 (CCCG-APL 2017), which was based on oral Realgar-Indigo naturalis formula. Results: A total of 79 pediatric APL patients were included and grouped according to the treatment plans, 56 patients were treated with CCAPL 2010 plan, and 23 patients were treated with CCCG-APL 2017 plan. The median costs of one single pediatric APL patient in CCAPL 2010 plan was 167 700 yuan (95 800-386 600 yuan), and the median hospital stay time of one single pediatric APL patient was 102 days (14-157 days). The median costs of one single pediatric APL patient in CCCG-APL 2017 plan group was 118 700 yuan(50 800-270 600 yuan), and the median hospital stay time of one single pediatric APL patient was 37 days(5-96 days). The costs and hospital stay time of one single pediatric APL patient with CCCG-APL 2017 plan were remarkably less than those of one single pediatric APL patient with CCAPL 2010 plan (U = 178, P < 0.01; U = 66, P < 0.01). Conclusions The CCCG-APL 2017 plan simplifies the treatment plan compared with the CCAPL 2010 plan and significantly reduces the patient's medical expenses and shortens the hospitalization days. The CCCG-APL 2017 plan is suitable for family therapy and has good social and economic benefits, which is worthy of clinical promotion.

In recent years,capecitabine is widely used in clinical practice.Hand-foot syndrome is a dose-limiting toxicity, often manifested as numbness in the hands and feet,sensation of dullness,tingling,skin swelling or erythema,scaling,blisters or seri-ous pain.Its occurrence has seriously affected the chemotherapy effect and daily life of patients.Genetic mutations of capecitabine met-abolic enzymes play an important role in the drug efficacy and side-effect.In particular,the relationship between gene polymorphisms of CDA,CES,TP,DPD,TYMS,MTHFR and hand-foot syndrome has been widely investigated and achieved by researchers.This arti-cle reviews the relationship between capecitabine metabolizing enzymes and hand-foot syndrome in order to provide a reference for i-dentifying the biological target of hand-foot syndrome caused by capecitabine chemotherapy.

Objective:To analyze the utilization of analgesics in ten cancer hospitals in China from 2013 to 2016;to analyze the use sta-tus of analgesics and auxiliary analgesics in Chinese patients with cancer, based on the three-step analgesic ladder principle an-nounced by the WHO and the guidelines of National Comprehensive Cancer Network(NCCN),and to provide data for the rational use of cancer analgesics in clinical practice.Methods:A retrospective analysis method was used to extract data on the use of analgesics and auxiliary analgesics in ten cancer hospitals in China between 2013 and 2016.Subsequently,statistical analyses were conducted on the dosage form of the drugs,the total consumption,the defined daily doses(DDDs),the defined daily cost(DDC),and the drug se-quence ratio(B/A).Results:Between 2013 and 2016,patients using analgesics in China comprised 12.6% of the total number of can-cer patients and the cost of analgesics accounted for 1.5% of the total cost of medication for all patients.The main analgesics used were opioids,which accounted for 90.9% of the cost of analgesics;the other types of analgesics,such as the anticonvulsant drugs, were increased.The major administration routes of analgesics in patients were oral,injectable,and topical routes.The DDD rankings of all types of analgesic treatment drugs were basically stable.The DDD values of fentanyl patches,estazolam,oxycodone oral dosage form,morphine oral dosage form,and indomethacin suppository were among the best.The DDC values for most analgesics did not change much,which reflected that price was stable.The DDC values of 13 analgesics were between 10 and 100.Most of the B/A val-ues of all kinds of analgesics were close to 1,with 17 between 0.5 and 1.5,comprised 58.6% of all types of drugs,which indicated that medication synchronization was good.Conclusions:The clinical applications of analgesics are increasing.In China,the treatment of cancer pain generally follows the three-step analgesic ladder principle announced by the WHO.However,there are also some prob-lems.For instance,the daily average cost of a few drugs was high and the synchronization was poor.Therefore,it is necessary to im-prove the management and regulate the treatment of cancer pain.

Objective To understand the prevalence of autism spectrum disorders (ASD) in children aged 0-6 years old and influencing factors in Hainan province.Methods A total of 37 862 children aged 0-6 years were selected from 18 counties in Hainan province for a screening by using questionnaire of "warning signs in child development",then field diagnosis was made,and general descriptive statistic analysis was conducted.The prevalence of ASD and related factors were analyzed with x2 test and unconditional logistic regression model.Results Among 37 862 children aged 0-6 years,235 were diagnosed with ASD,the prevalence of ASD was 0.62％ (0.99％ in boys,0.17％ in girls),the differences was significant (x2=101.91,P=0.000).The prevalence of ASD increased with age (x2=288.62,P=0.000).The prevalence of ASD was significantly higher in urban area than in other areas (x2=114.77,P=0.000).Factors such as full term pregnancy or not,neonatal asphyxia,father' s characteristics,father' s habit of chewing areca or smoking,mother' s general mood,and mother' s induced abortion history were the influencing factors for ASD.Conclusion The prevalence of ASD in children aged 0-6 years was high in Hainan and was influenced by genetic factors,pregnancy and delivery process,parents unhealthy habit before and during pregnancy and other factors.