Objective To explore an artificial intelligence (AI)-based method for automated hand hygiene monitoring and to compare the effectiveness of three algorithms (UniFormerV2, TDN, C3D) in recognizing hand hygiene steps in surgical settings, thereby aiding hospital infection control. Methods From April to October 2024, we non-invasively collected 641 video recordings of healthcare staff performing hand hygiene at four-bay scrub sinks in two tertiary hospitals using overhead HD cameras. The dataset was annotated by five trained experts for model training and validation. Results Following training on 385 samples, internal validation (n=119) showed the C3D model achieved 81% accuracy, 87% recall, and an 83% F1-score. The TDN model achieved 93%, 91%, and 92% for the same metrics. The UniFormerV2 model outperformed both, with an accuracy, recall, and F1-score of 93%—an improvement of over 10 percentage points compared to traditional CNNs (TDN, C3D). It also achieved an 84% accuracy in external validation, demonstrating strong generalization. Conclusion The UniFormerV2 model is more accurate than CNN-based models for hand hygiene step recognition and shows robust performance in external validation. It presents a viable tool for healthcare facilities to enhance hand hygiene management, ultimately improving medical quality and patient safety.

ObjectiveTo investigate the effects of luteinizing hormone （LH） levels on in vitro fertilization and embryo transfer （IVF-ET） outcomes in an infertile population with normal ovarian reserve （NOR） undergoing controlled ovarian hyperstimulation （COH） with gonadotropin-releasing hormone antagonist protocol， and to explore the reasonable level intervals of LH during the follicular phase. MethodsA retrospective analysis was conducted on 911 NOR infertility patients undergoing IVF-ET treated with gonadotropin-releasing hormone antagonist protocol. Patients were grouped based on baseline LH （bLH） levels， LH levels on the day of antagonist addition， and LH levels on the day of human chorionic gonadotropin （hCG） injection. According to bLH levels， patients were divided into Group A2 （n=391） and Group B2 （n=391）. Based on LH levels on the day of antagonist addition， patients were divided into Group A3 （n=600） and Group B3 （n=311）. According to LH levels on the day of hCG injection， patients were classified into Group A4 （n=225）， Group B4 （n=227）， Group C4 （n=231）， and Group D4 （n=228）. The clinical characteristics， COH outcomes， and pregnancy outcomes of patients in each group were compared. Results① The bLH level could be used as a predictor of assisted reproduction outcomes in an infertile population with NOR， and going for assisted reproduction at bLH≥4.51 IU/L was more favorable for the development of pregnancy outcomes； ② Addition of antagonist at LH≥5 IU/L on the day of antagonist addition improved pregnancy outcome ；③ On the day of hCG injection， there was no statistically significant difference in pregnancy outcomes among the four groups； ④ Analyses using generalized linear models revealed that basal follicle-stimulating hormone （bFSH）， basal estradiol （bE₂）， Gn days， Gn volume and 2PN affected the number of good quality embryos. ConclusionIn an infertile population with NOR using gonadotropin-releasing hormone antagonist， bLH and gonadotropin-releasing hormone antagonist addition day LH levels may influence IVF outcomes. LH levels should be controlled at 5 IU/L and above on antagonist addition days， and bLH levels should be controlled at 4.51 IU/L and above.

Continuous manufacturing, as an innovative pharmaceutical production model, offers advantages such as high production efficiency and ease of control compared to traditional batch production, aligning with the future trend of drug production moving toward greater efficiency and intelligence. However, the development of continuous manufacturing technology in wet granulation has been slow. On one hand, this is closely related to its high technical complexity, substantial equipment investment costs, and stringent process control requirements. On the other hand, the long-term use of the traditional batch production model has created strong path dependence, and the lack of mature standardized processes further increases the difficulty of technological transformation. To promote the deep integration of wet granulation technology with continuous manufacturing, this review systematically outlines the current application of wet granulation in continuous manufacturing. It focuses on the development of key technologies such as online detection, process modeling, and process scale-up, with the aim of providing a reference for process innovation and application in wet granulation.
Drug Compounding/instrumentation* ; Technology, Pharmaceutical/methods* ; Drugs, Chinese Herbal/chemistry* ; Models, Theoretical

Acute lung injury(ALI) is a critical clinical condition primarily characterized by refractory hypoxemia and infiltration of inflammatory cells in lung tissue, which can progress into a more severe form known as acute respiratory distress syndrome(ARDS). Immune cells and inflammatory cytokines play important roles in the progression of the disease. Due to its unclear pathogenesis and the lack of effective clinical treatments, ALI is associated with a high mortality rate and severely affects patients' quality of life, making the search for effective therapeutic agents particularly urgent. Ginseng Radix et Rhizoma, the dried root of the perennial herb Panax ginseng from the Araliaceae family, contains active ingredients such as saponins and polysaccharides, which possess various pharmacological effects including anti-tumor activity, immune regulation, and metabolic modulation. In recent years, studies have shown that ginsenosides exhibit notable effects in reducing inflammation, ameliorating epithelial and endothelial cell injury, and providing anticoagulant action, indicating their comprehensive role in alleviating lung injury. This review summarizes the pathogenesis of ALI and the molecular mechanisms through which ginsenosides act at different stages of ALI development. The aim is to provide a scientific reference for the development of ginsenoside-based drugs targeting ALI, as well as a theoretical basis for the clinical application of Ginseng Radix et Rhizoma in the treatment of ALI.
Ginsenosides/pharmacology* ; Humans ; Acute Lung Injury/immunology* ; Animals ; Panax/chemistry* ; Drugs, Chinese Herbal

OBJECTIVE: To explore the early clinical outcomes of 3D printed individualised customised prostheses for in hip revision in patients with combined severe bone defects. METHODS: Twenty-two patients from January 2021 to May 2023 underwent hip revision using 3D printed personalised customised prostheses were retrospective analyzed, including 10 males and 12 females, age 28 to 78 with a mean of (58.9±12.8) years old. All of patients were combined with severe bone defects (Parprosky type Ⅲ). Among of them, 9 patients had periprosthetic infections and 13 patients had aseptic prosthesis loosening. All patients were treated with a 3D printed personalised prosthesis protocol, patients with the periprosthetic infection received a second stage revision after infection control. The operation time, preoperative waiting time, intraoperative and postoperative complications were recorded, and the clinical efficacy were evaluated at the final follow-up using the visual analogue scale (VAS) for pain, the Harris hip score. RESULTS: One patient was lost to follow-up and the remaining 21 patients were followed up for 10 to 15 with a mean of (12.91±1.44) months after surgery. All patients completed surgery as planned, with an operative time of 135 to 390 with a mean of (165.4±39.3) minutes and a preoperative waiting time of 7 to 16 with a mean of (10.5±3.3) days. Regarding patient complications:one patient had a severe intraoperative periprosthetic femoral fracture due to the combination of severe osteoporosis; one patient had an intraoperative greater trochanteric femur fracture. At the latest follow-up, all patients had good position of the custom-made prosthesis and no loosening of the prosthesis;all patients had good wound healing and no local redness or swelling. The total Harris score at the final follow-up (85.86±7.04) was significantly improved compared to the preoperative (44.86±2.36), P<0.001. The VAS at the last follow-up (2.19±0.87) was significantly improved compared with preoperative (7.41±0.96), P<0.001. CONCLUSION The clinical efficacy of 3D-printed personalised customised prosthesis in combined severe bone defect hip revision is satisfactory, but due to the increased preoperative waiting time of the patients and certain risks, certain indications should be mastered when applying in the clinic.
Humans ; Male ; Female ; Printing, Three-Dimensional ; Middle Aged ; Aged ; Adult ; Retrospective Studies ; Hip Prosthesis ; Arthroplasty, Replacement, Hip ; Reoperation ; Prosthesis Design ; Treatment Outcome

OBJECTIVE: To observe the efficacy and safety of 21-day venetoclax (VEN) plus azacitidine (AZA) (21-day VA) in newly diagnosed unfit acute myeloid leukemia (AML) patients in the real-world. METHODS: The clinical data of patients with unfit-AML who received 21-day VA regimen from December 2020 to July 2024 in our center and completed at least 1 cycle of therapeutic effect assessment was retrospectively collected to analyze the safety, efficacy and its influencing factors. RESULTS: A total of 59 patients were enrolled in our study, with a median age of 67(48-87) years old. After 1 cycle of therapy, the composite complete remission (cCR) rate was 74.5%, 54.2% of cases were negative for minimal residual disease (MRD). Among them, the MRD negative rate of patients with NPM1 mutation was significantly higher than that of patients without NPM1 mutation ( P =0.032). The median follow-up of patients was 19(2-38) months, the best cCR and MRD negative rates were 78% and 64.4%, respectively, the median overall survival (OS) time was 12 months, and the median progression free survival (PFS) time was 5 months. Multivariate Cox regression analysis showed less than 4 cycles of VA chemotherapy were independent risk factor for PFS and OS ( P < 0.05). After achieving remission, anemia and thrombocytopenia improved with the increase of the number of chemotherapy cycle. CONCLUSION In real-world, 21-day VA regimen still shows significant efficacy in the treatment of newly diagnosed unfit-AML, without adversely affecting remission rate and MRD negative rate of the first cycle.
Humans ; Leukemia, Myeloid, Acute/drug therapy* ; Aged ; Middle Aged ; Bridged Bicyclo Compounds, Heterocyclic/therapeutic use* ; Sulfonamides/therapeutic use* ; Azacitidine/therapeutic use* ; Aged, 80 and over ; Male ; Female ; Retrospective Studies ; Nucleophosmin ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Remission Induction ; Mutation ; Treatment Outcome

AIM To establish a UPLC-MS/MS method for the simultaneous content determination of isofraxidin,saikosaponin c,ginsenoside Re,puerarin,rosmarinic acid,praeruptorin A,daidzein,baicalin and 5-O-methylvisammioside in Chaige Changyuan Mixture.METHODS The analysis was performed on a 35 ℃ Titank C18 column(100 mm×2.1 mm,3 μm),with the mobile phase comprising of acetonitrile-0.1％formic acid flowing at 0.3 mL/min in a gradient elution manner,and electron spray ionization source was adopted in positive and negative ion scanning with multiple reaction monitoring mode.RESULTS Nine constituents showed good linear relationships within their own ranges(r≥0.999 0),whose average recoveries were 84.08％-115.40％with the RSDs of 0.21％-4.47％.CONCLUSION This efficient,simple,sensitive and specific method can be used for the quality control of Chaige Changyuan Mixture.

Objective:To formulate the Guidelines for the Construction of Community Health Service Centers in Pudong New Area, Shanghai. Methods:This was a qualitative study. This study was divided into 2 stages. The first stage of the study was conducted from June to August 2023 and involved the heads of the General Affairs Departments of the 47 community health service centers in Pudong New Area. These individuals completed online questionnaires to compile a database on the current status of matching supply and demand resources in community health service centers in Pudong New Area. The second stage of the study run from September 2023 to August 2024. Firstly, the functional modules of China′s community health service centers would be clarified through a literature review. The construction scale and design requirements of similar institutions at home and abroad would be benchmarked, as well as practical experience. The results of Phase 1 research would then be combined to form the " Community Health Service Center Infrastructure Configuration Requirements and Design Suggestions (Draft)". Then, relevant experts were brought together to discuss the draft and form the " Community Health Service Center Infrastructure Configuration Requirements and Design Recommendations (Revised Version)". The experts involved in the discussion specialized in the study of infrastructure resource allocation for medical institutions. Finally, the medical and healthcare system managers, community health service center users, and relevant commissions and bureaus of Pudong New Area were consulted to further revise and finalize the Guidelines for the Construction of Community Health Service Centers in Pudong New Area, Shanghai. Results:The total floor area of community health service centers in Pudong New Area was 57% (31/55), the number of beds per 1 000 people was 14% (8/55), and the total number of beds was 10% (6/60). These figures showed that urgent upgrades and construction in accordance with the new standards were required. The final " Guidelines for the Construction of Community Health Service Centers" of Shanghai Pudong New Area comprised 15 chapters, covering topics from the macro construction scale, site selection and general plan to architectural design, structural design, water supply and sewage treatment, ventilation and air conditioning, electrical systems, informatics, medical gas supply, indoor design, signage, marking and fire protection, etc. The guidelines have been revised to incorporate the functional design of the 5 basic rooms, with a particular focus on the creating humanistic spaces and promoting digitalization. Particular attention was paid to creating humanistic spaces and improving ageing with digital applications. Conclusions:The Guidelines for the Construction of Community Health Service Centers in Pudong New Area of Shanghai have been successfully formulated. These guidelines can be used to guide the subsequent high-quality and standardized development of community health service centers.

Objective:To explore the impact of a three-dimensional management based on a perinatal one-day clinic on pregnancy outcomes in overweight and obese pregnant women.Methods:It was a randomized controlled trial. A simple random sampling method was used to select 460 singleton pregnant women with a pre-pregnancy body mass index≥24 kg/m2 who had regular prenatal check-ups at the Obstetrics and Gynecology Center of the Third Affiliated Hospital of Chongqing Medical University from June 1, 2018, to December 31, 2022. The women were randomly divided into an experimental group and a control group (230 cases each) using a computer-generated random number table. The control group received regular prenatal check-ups according to the pregnancy care guidelines (once every 4 weeks during mid-pregnancy, once every 2 weeks during late pregnancy, with additional frequency as needed based on the condition). The control group also received a one-time body composition analysis and dietary guidance from a nutritionist at the time of registration. In addition to the control group′s interventions, the experimental group received three-dimensional management based on a perinatal one-day clinic. It included an intensive one-day clinic session, a traditional plus internet-based re-education model (as needed based on the condition), individualized guidance from obstetrics and clinical nutrition clinics (once every 2 weeks), a free body composition test at 24 weeks of pregnancy, and weekly WeChat group push of health care knowledge during pregnancy. A total of 55 cases dropped out, leaving 200 cases in the experimental group and 205 cases in the control group for analysis. General information, pregnancy-related, and postpartum indicators were collected in the two groups. The effect of three-dimensional management based on a perinatal one-day clinic on pregnancy outcomes in overweight and obese pregnant women was analyzed using t-tests and chi-square tests. Results:There was no significant differences in baseline age, pre-pregnancy body mass index, initial blood glucose, initial glycated hemoglobin, or initial gestational age between the two groups (all P>0.05). The experimental group showed significantly lower gestational weight gain, neonatal weight, and proportion of excessive pregnancy weight gain compared to those in the control group [(11.41±5.23) vs (13.22±4.51) kg, (3 352.1±465.3) vs (3 489.5±464.0) g, 48.00% vs 73.17%] (all P<0.05). There were no significant differences in hospitalization days, gestational age at delivery, incidence of gestational diabetes, incidence of hypertensive disorders of pregnancy, incidence of premature rupture of membranes, incidence of preterm birth, incidence of macrosomia, vaginal delivery rate and rate of neonatal transfer to the pediatric department between the two groups (all P>0.05). Conclusion:Early intervention with the three-dimensional management based on the one-day perinatal clinic can effectively control gestational weight gain and neonatal weight in overweight and obese pregnant women.

Occipital lobe epilepsy （OLE） accounts for 5%-10% of all focal epilepsy cases. Ictal clinical symptoms mainly include visual and ocular movements， with common and specific elementary visual hallucinations. Electroencephalography has certain limitations， and a well-localized unifocal rhythmic ictal discharge during seizure is infrequent on ictal EEG. Detailed preoperative evaluation， especially the evaluation of symptoms and intracranial EEG monitoring， can help to obtain good outcomes after surgical treatment.