Objectives:To investigate the short-term effect of soft endoscope-assisted single-segment cervical artificial disc replacement(ADR)in the treatment of cervical spondylosis.Methods:A retrospective analysis was conducted on the clinical data of 24 cases of cervical spondylosis treated with soft endoscope-assisted single-segment ADR in our hospital from June 2023 to May 2024,of which,8 cases were male and 16 cas-es were female,aged 25 to 68 years old(47.0±11.9 years old).There were 7 cases of cervical spondylotic radiculopathy,14 cases of cervical spondylotic myelopathy,and 3 cases of mixed cervical spondylosis.All of the patients were with single-segment lesions,including 2 cases of C3/4,6 cases of C4/5,12 cases of C5/6,and 4 cases of C6/7.The length of surgical incision,intraoperative bleeding,operative time,postoperative drainage,hospitalization time and complications were recorded;Prevertebral soft tissue edema was evaluated;Japanese Orthopaedic Association(JOA)score was assessed for cervical spine motor function,and visual analog scale(VAS)score was evaluated for neck and shoulder pain on 1d before surgery,at 1 week after surgery,1 month and 3 months after surgery.Results:Surgery was successfully completed in all patients,and no com-plications such as spinal cord/nerve root injury or cerebrospinal fluid leakage were detected during the opera-tion.Operative time was 34-123min(66.6±20.8min),length of surgical incision was 2.5-3cm(2.6±0.2cm),intra-operative bleeding volume was 5-50mL(19.6±12.6mL),postoperative drainage volume was 0-60mL(13.5±18.8mL),and postoperative hospitalization time was 3-8d(5.1±1.6d).No postoperative complications such as cervical subcutaneous hematoma and dysphagia were observed.Postoperative imaging revealed no significant prevertebral soft tissue edema.The postoperative VAS and JOA scores were significantly improved at all time points compared with the preoperative values(P＜0.05).The overall efficacy was assessed according to the im-provement rate of JOA score at 3 months after surgery:12 cases were excellent,12 cases were good,and the rate of excellent and good was 100％(24/24).Conclusions:Soft endoscope-assisted single-segment ADR for the treatment of cervical spondylosis is small in trauma and short in operative time,which has certain clinical application prospects.

Objective To determine the body weights and blood physiological and biochemical indicators in the Macaca mulatta brevicaudus(M.m.brevicaudus),to provide a reference for the breeding of experimental animals.Methods A total of 180 wild M.m.brevicaudus(female and male)from the South Bay Macaque Reserve in Lingshui were selected as the research subjects.Body weights were measured using electronic scales and blood samples were collected.Routine blood indicators(red blood cell count,hemoglobin,white blood cell count,and platelet count)were detected using an automated blood cell analyzer,and biochemical indicators(alanine aminotransferase,aspartate aminotransferase,glucose,blood urea nitrogen)were measured using an automated biochemical analyzer.Data were analyzed using SPSS 18.0 software for descriptive statistics,and differences in body weights and blood indicators between sexes and age groups were compared using t-tests.Results Adult male wild M.m.brevicaudus were significantly heavier than females(P＜0.05);however,there were no significant differences in complete blood cell counts between female and male macaques(P＞0.05).In terms of blood biochemical indicators,lactate dehydrogenase and total bilirubin levels differed significantly between female and male M.m.brevicaudus(P＜0.05),but there were no significant differences in any other biochemical indicators.Conclusions This study established baseline data on the body weights and blood physiological and biochemical indicators of wild M.m.brevicaudus,providing a reference for their future breeding as experimental animals.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Objective To determine the body weights and blood physiological and biochemical indicators in the Macaca mulatta brevicaudus(M.m.brevicaudus),to provide a reference for the breeding of experimental animals.Methods A total of 180 wild M.m.brevicaudus(female and male)from the South Bay Macaque Reserve in Lingshui were selected as the research subjects.Body weights were measured using electronic scales and blood samples were collected.Routine blood indicators(red blood cell count,hemoglobin,white blood cell count,and platelet count)were detected using an automated blood cell analyzer,and biochemical indicators(alanine aminotransferase,aspartate aminotransferase,glucose,blood urea nitrogen)were measured using an automated biochemical analyzer.Data were analyzed using SPSS 18.0 software for descriptive statistics,and differences in body weights and blood indicators between sexes and age groups were compared using t-tests.Results Adult male wild M.m.brevicaudus were significantly heavier than females(P＜0.05);however,there were no significant differences in complete blood cell counts between female and male macaques(P＞0.05).In terms of blood biochemical indicators,lactate dehydrogenase and total bilirubin levels differed significantly between female and male M.m.brevicaudus(P＜0.05),but there were no significant differences in any other biochemical indicators.Conclusions This study established baseline data on the body weights and blood physiological and biochemical indicators of wild M.m.brevicaudus,providing a reference for their future breeding as experimental animals.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Objectives:To investigate the short-term effect of soft endoscope-assisted single-segment cervical artificial disc replacement(ADR)in the treatment of cervical spondylosis.Methods:A retrospective analysis was conducted on the clinical data of 24 cases of cervical spondylosis treated with soft endoscope-assisted single-segment ADR in our hospital from June 2023 to May 2024,of which,8 cases were male and 16 cas-es were female,aged 25 to 68 years old(47.0±11.9 years old).There were 7 cases of cervical spondylotic radiculopathy,14 cases of cervical spondylotic myelopathy,and 3 cases of mixed cervical spondylosis.All of the patients were with single-segment lesions,including 2 cases of C3/4,6 cases of C4/5,12 cases of C5/6,and 4 cases of C6/7.The length of surgical incision,intraoperative bleeding,operative time,postoperative drainage,hospitalization time and complications were recorded;Prevertebral soft tissue edema was evaluated;Japanese Orthopaedic Association(JOA)score was assessed for cervical spine motor function,and visual analog scale(VAS)score was evaluated for neck and shoulder pain on 1d before surgery,at 1 week after surgery,1 month and 3 months after surgery.Results:Surgery was successfully completed in all patients,and no com-plications such as spinal cord/nerve root injury or cerebrospinal fluid leakage were detected during the opera-tion.Operative time was 34-123min(66.6±20.8min),length of surgical incision was 2.5-3cm(2.6±0.2cm),intra-operative bleeding volume was 5-50mL(19.6±12.6mL),postoperative drainage volume was 0-60mL(13.5±18.8mL),and postoperative hospitalization time was 3-8d(5.1±1.6d).No postoperative complications such as cervical subcutaneous hematoma and dysphagia were observed.Postoperative imaging revealed no significant prevertebral soft tissue edema.The postoperative VAS and JOA scores were significantly improved at all time points compared with the preoperative values(P＜0.05).The overall efficacy was assessed according to the im-provement rate of JOA score at 3 months after surgery:12 cases were excellent,12 cases were good,and the rate of excellent and good was 100％(24/24).Conclusions:Soft endoscope-assisted single-segment ADR for the treatment of cervical spondylosis is small in trauma and short in operative time,which has certain clinical application prospects.

Objective:To investigate the effect of core strength training based on total resistance exercise (TRX) for the flying personnel with nonspecific low back pain (NLBP).Methods:Flying personnel with NLBP who recuperated in Air Force Healthcare Center for Special Services Hangzhou from October of 2019 to June of 2021 were selected. They were divided into test group and control group by simple random sampling. The test group received 4 weeks of TRX core strength training, and the control group received 4 weeks of traditional core strength training. The isokinetic muscle strength testing instrument was used to measure the muscle strength characteristics of lumbar and abdominal flexor and extensor muscle groups of the subjects. The differences in Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were compared between 2 groups before and after training.Results:A total of 40 subjects were included with 20 cases in the test group and 20 cases in the control group, all of them were helicopter flying personnel. After training, the scores of VAS in both groups were lower than those before training ( t=22.01, 17.15, both P<0.001), and the VAS score of the test group was lower than that of the control group, with a significant difference ( t=6.55, P<0.001). After training, the ODI scores of subjects in both groups were lower than those before training ( t=32.05, 27.45, both P<0.001), and the score of the test group was lower than that of the control group, with a significant difference ( t=4.85, P<0.001). After training, the relative peak moment of lumbar and abdominal flexor and extensor muscle groups of the test group were higher than those of control group, and the differences were significant ( t=2.65, 2.41, 2.04, 3.31, P=0.026, 0.037, 0.047, 0.005). Conclusions:TRX core strength training can significantly improve the muscle strength of the lumbar and abdominal flexor and extensor muscle groups of flying personnel with NLBP, which can be used as a training program to prevent NLBP for flying personnel.

Objective:To investigate the effect of core strength training based on total resistance exercise (TRX) for the flying personnel with nonspecific low back pain (NLBP).Methods:Flying personnel with NLBP who recuperated in Air Force Healthcare Center for Special Services Hangzhou from October of 2019 to June of 2021 were selected. They were divided into test group and control group by simple random sampling. The test group received 4 weeks of TRX core strength training, and the control group received 4 weeks of traditional core strength training. The isokinetic muscle strength testing instrument was used to measure the muscle strength characteristics of lumbar and abdominal flexor and extensor muscle groups of the subjects. The differences in Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were compared between 2 groups before and after training.Results:A total of 40 subjects were included with 20 cases in the test group and 20 cases in the control group, all of them were helicopter flying personnel. After training, the scores of VAS in both groups were lower than those before training ( t=22.01, 17.15, both P<0.001), and the VAS score of the test group was lower than that of the control group, with a significant difference ( t=6.55, P<0.001). After training, the ODI scores of subjects in both groups were lower than those before training ( t=32.05, 27.45, both P<0.001), and the score of the test group was lower than that of the control group, with a significant difference ( t=4.85, P<0.001). After training, the relative peak moment of lumbar and abdominal flexor and extensor muscle groups of the test group were higher than those of control group, and the differences were significant ( t=2.65, 2.41, 2.04, 3.31, P=0.026, 0.037, 0.047, 0.005). Conclusions:TRX core strength training can significantly improve the muscle strength of the lumbar and abdominal flexor and extensor muscle groups of flying personnel with NLBP, which can be used as a training program to prevent NLBP for flying personnel.

Objective:To investigate the prognostic value of tumor infiltrating lymphocytes (TILs) and their phenotypes, CD4 + TILs, CD8 + TILs and FOXP3 + TILs, in short-term prognosis (PCR) and long-term prognosis (DFS, OS) of triple negative breast cancer (TNBC), and to provide theoretical support for the immunotherapy of TNBC. Methods:A systematic surch of PubMed, Medline, Embase, Web of Science, CBM, CNKI was conducted to identified eligible articles. All prospective trials and observational controlled trials published before August 2020 were retrieved.The two authors independently evaluated the quality of the included literature, extracted the data, and conducted systematic evaluation and analysis using RevMan5.3 software.Results:A total of 48 literatures were included.Every 10% increase in TILs and TILs expression in the high-expression group predicted a higher PCR, OR were 1.81 (95% CI: 1.44-2.28) and 1.09 (95% CI: 1.02-1.15). For longer survival, the HR for DFS and OS were 0.99 (95% CI: 0.98-0.99) and 0.90 (95% CI: 0.86-0.94), 0.87 (95% CI: 0.79-0.96) and 0.88 (95% CI: 0.83-0.92). Phenotypic CD4 + TILs, CD8 + TILs, and FOXP3 + TILs did not show statistically significant differences in PCR among patients, but in long-term prognosis, higher infiltration predicted longer survival, with HR for DFS of 0.54 (95% CI: 0.36-0.80), 0.46(95% CI: 0.33-0.64) and 0.45(95% CI: 0.31-0.68). HR of OS were 0.49 (95% CI: 0.32-0.76), 0.59 (95% CI: 0.54-0.66) and 0.44 (95% CI: 0.27-0.71). Conclusion:The infiltration degree of TILs and the increase of TILs expression by 10% can be used as a prognostic index of TNBC.High levels of phenotypic infiltration of CD4 + TILs, CD8 + TILs, and FOXP3 + TILs predicted better long-term survival, but there was no statistically significant difference in short-term survival.

Objective: To investigate the current basic situation of ultrasound machines of ultrasound departments in Shanghai medical institutions, and to provide the basis for making management policy in order to promote medical quality. Methods: Questionnaire surveys about ultrasound machines and service ability including producing countries of ultrasound machines, the number of ultrasound machines, using years of ultrasound machines, yearly workload and the yearly number of patients that each ultrasound machine accepted were made in 2013 and 2018, respectively. Statistical results were compared between the two surveys. Results: Compared with 2013, the share of imported ultrasound machines declined in 2018 (82% vs 91%). Compared with 2013, the number of ultrasound machines in Shanghai medical institutions had increased by 31% in 2018 (2 123 vs 1 617). The occupancy rate of ultrasound machines in tertiary hospitals was the highest (tertiary hospitals 40%, secondary hospitals 25%, primary grade hospitals 20%, and private hospitals 15%). Compared with 2013, the proportion of ultrasound machines that have been used for more than 10 years increased (9% vs 4%), the yearly workload of ultrasound examination had increased by 46% (19.82 million person-time vs 13.59 million person-time). Tertiary hospitals bored the highest proportion of the workload (tertiary hospitals 51%, secondary hospitals 35%, primary grade hospitals 4%, and private hospitals 10%). Currently, the number of ultrasound machines per 10, 000 people in Shanghai was 1.14. The yearly number of patients that each ultrasound machine accepted had increased by 11% (9300 person-time vs 8400 person-time in 2018). Conclusions The scale of ultrasound departments in Shanghai medical institutions has been developing. Brand localization of ultrasound machines is improving. However, the renewal ability of ultrasound machines still needs to be improved. The workload of ultrasound department is getting heavier. Hierarchical diagnosis and treatment is unbalanced.