To address the challenges associated with traditional medical treatment modalities that hinder the efficiency of healthcare delivery,and to facilitate the sharing of medical service information across multiple campuses via mobile platforms,the First Affiliated Hospital to Zhejiang University School of Medicine has proactively leveraged digital intelligence to innovate its medical service model.This program involved the development of a comprehensive process guidance service applet on the Alipay platform specifically for outpatient services.The applet offers intelligent support services,standardizes electronic authentication processes,coordinates medical resources across various hospital locations,and establishes an integrated service delivery system that seamlessly combines online and offline interactions.This approach has optimized the outpatient treatment process,enhanced the patient experience,and fostered standardized management of medical services across multiple campuses.

To address the challenges associated with traditional medical treatment modalities that hinder the efficiency of healthcare delivery,and to facilitate the sharing of medical service information across multiple campuses via mobile platforms,the First Affiliated Hospital to Zhejiang University School of Medicine has proactively leveraged digital intelligence to innovate its medical service model.This program involved the development of a comprehensive process guidance service applet on the Alipay platform specifically for outpatient services.The applet offers intelligent support services,standardizes electronic authentication processes,coordinates medical resources across various hospital locations,and establishes an integrated service delivery system that seamlessly combines online and offline interactions.This approach has optimized the outpatient treatment process,enhanced the patient experience,and fostered standardized management of medical services across multiple campuses.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Objective: To explore the clinical applications of second generation colon capsule endoscopy (CCE-2). Methods: From July 2017 to December 2018, at the First Affiliated Hospital, College of Medicine, Zhejiang University, 40 outpatients and hospitalized patients who underwent CCE-2 examination were enrolled. The examination results were analyzed by an expert gastroenterologist with rich experience in small intestinal and colon capsule endoscopy. The stomach, small bowel and colon transit time, the score of colon cleansing quality, the completion rate of colon capsule examination, lesion detection and adverse effects were observed. Chi-square test and Student′t test were used for statistical analysis. Results: The whole gastrointestinal tract examination was completed during the capsule running time in 65.0% (26/40) of the patients. The average stomach transit time was (0.92±0.74) h, the small bowel transit time was (3.93±1.51) h and the colon transit time was (4.89±0.61) h. The capsule running time of patients who completed the whole gastrointestinal tract examination was shorter than that of patients who did not complete the whole gastrointestinal tract examination ((9.44 ± 3.53) h vs. (15.47±2.09) h), and the difference was statistically significant (t=6.79, P<0.01). The qualified rate of colon preparation was 67.5% (27/40). There were no statistically significant differences in colon transit time or capsule excretion time between patients with qualified colon preparation and poor colon preparation ((4.43±3.33) h vs. (5.96 ± 2.44) h; and (9.06 ± 3.91) h vs. (10.29±2.47) h; t=1.17 and 0.81, both P>0.05). A total of 33 (82.5%) patients had gastrointestinal lesions detected by colon capsule, including three cases of esophageal lesions (inflammation and mass), 21 cases of gastric lesions (chronic gastritis, mucosal protrusion, polyp and ulcer), nine cases of small bowel lesions (polyp, ulcer and vascular malformation) and 19 cases of colonic lesions (diverticulum, polyp, rectitis, mucosal erosion, ulcer and vascular malformation, internal hemorrhoids). Among them, there were 11 patients with two or more lesions. No adverse events occurred during the examination and all the capsules were excreted within 48 hours. Conclusion CCE-2 with high safety and good tolerance can be used for whole gastrointestinal tract examination.

OBJECTIVE: To analyze the inter-laboratory comparison results of occupational hygiene laboratories of Guangdong Province. METHODS: The 42 laboratories that continuously participated in the inter-laboratory comparison of occupational hygiene technical service institutions in Guangdong Province from 2014 to 2018 were selected as the research subjects Guangdong Occupational Health Test Center from 2014 to 2018 were selected by convenient sampling method. The data of detection of organic compounds, metal element, non-metal element in the workplace air, detection of metal element in biological materials, and the detection of free silica in dust were analyzed. The results were statistically analyzed by four-point robust statistical technique. RESULTS: From 2014 to 2018, a total of 1 205 items of sample detection results were submitted in these 5 years. The qualified rate of sample test was 92.4%(1 114/1 205) in these laboratories. The qualified rate of test of organics in workplace air, metals in workplace air, inorganic non-metals in workplace air, metals in biological materials and free silica in dust were 93.3%, 94.4%, 91.6%, 84.4% and 91.8% respectively. There was no significant difference in the qualified rate of sample test between the laboratories in the Pearl River delta in Guangdong Province and the laboratories in other regions the laboratories in other regions(92.8% vs 89.6%, P>0.05). There was no significant difference in the qualified rate of sample test among the occupational disease prevention and treatment institute, center for disease control and prevention and private laboratories(93.1% vs 93.6% vs 89.0%, P>0.05). Among the 91 unqualified items, 35 items were │z score of inter-laboratory(z_B)│≥ 3(38.5%), 40 items were │z score of within-laboratory(z_w)│≥ 3(44.0%), and 16 items were│z_B│≥ 3 and │z_w│≥ 3(17.6%). CONCLUSION: The laboratories in Guangdong Province that participated in the inter-laboratory comparison of occupational health test for 5 consecutive years have a relatively high level of occupational health testing, and the test results are accurate.

Objective To investigate the correlation between capsule endoscopy Crohn′s disease activity index (CECDAI ) , capsule endoscopy Lewis score , simplified Crohn′s disease activity index (sCDAI) ,C reactive protein (CRP) ,erythrocyte sedimentation rate (ESR) and Crohn′s disease (CD) activity .Methods From April 2009 to April 2014 , 120 patients having received capsule endoscopy examination and diagnosed as CD were collected . The data of CRP and ESR were analyzed . The CD severity was scored by CECDAI ,Lewis score and sCDAI .Spearman correlation was performed to analyze the correlation between CECDAI ,Lewis score ,sCDAI ,CRP and ESR .Results Among all the patients , CECDAI had a good correlation with Lewis score (r=0 .645 , P< 0 .01) and also was correlated with sCDAI (r=0 .190 , P< 0 .05) ,CRP and ESR (r= 0 .315 and 0 .393 ,both P< 0 .01) .However ,the Lewis score was not correlated with sCDAI ,CRP and ESR (r=0 .052 ,0 .041 and 0 .021 ,all P>0 .05) . sCDAI had a good correlation with CRP and ESR (r=0 .438 and 0 .429 ,both P<0 .01) .Among patients whose capsule endoscope failed to pass through the whole small intestinal ,the CECDAI had no significant correlation with sCDAI ,CRP and ESR (r=0 .126 ,0 .181 and 0 .269 ,all P>0 .05) .Conclusions Lewis score ,sCDAI ,CRP and ESR can reflect disease activity of CD patients in a certain degree .CECDAI is the most suitable index in evaluating the disease activity of CD patients .Therefore ,it is necessary to attach importance to capsule endoscopy examination .

OBJECTIVETo understand the risk factors of measles among babies under 8-months-old and people ≥15 years old, in Gansu province.

METHODSLaboratory-confirmed measles cases were divided into two groups among children below 8-months-old and those ≥15 year olds. Descriptive epidemiology and 1:3 case control study were conducted to find out those related risk factors as:hospital exposure, contact with measles cases, vaccination, history of measles etc. so as to determine the risk factors and appropriate control measures.

RESULTSHistories of hospital exposure, contact with measles cases and travelling to other cities were risk factors for measles among babies younger than 8-months and people ≥15 year olds. Vaccination appeared a protective factor for people ≥15 years of age. From 42 cases and 126 controls, through multivariate analysis, results showed that hospital exposure was the only significant factor ( OR = 29.23, 95%CI:2.82-302.89)for those babies younger than 8-months. Factors as hospital exposure and travelling among cities for 7-21 days before being infected, were with significant importance ( OR = 5.15, 95% CI:2.28-11.63; OR = 5.48, 95%CI:1.38-21.69)for people ≥15 years of age, according to the observation from 74 cases and 222 controls.

CONCLUSIONIn order to reduce the incidence of measles among babies under 8-month-old and people ≥15 years old, efforts on control of nosocomial infection should be strengthened, while the routine immunization coverage need to be increased for the children at higher risks, to reduce the source of infection.

Adolescent ; Case-Control Studies ; China ; epidemiology ; Cross Infection ; Humans ; Incidence ; Infant ; Measles ; diagnosis ; epidemiology ; prevention & control ; Measles Vaccine ; administration & dosage ; Risk Factors ; Vaccination ; utilization

Objective To understand the risk factors of measles among babies under 8-months-old and people ≥15 years old,in Gansu province. Methods Laboratory-confirmed measles cases were divided into two groups among children below 8-months-old and those≥15 year olds. Descriptive epidemiology and 1∶3 case control study were conducted to find out those related risk factors as:hospital exposure,contact with measles cases,vaccination,history of measles etc. so as to determine the risk factors and appropriate control measures. Results Histories of hospital exposure,contact with measles cases and travelling to other cities were risk factors for measles among babies younger than 8-months and people≥15 year olds. Vaccination appeared a protective factor for people ≥15 years of age. From 42 cases and 126 controls,through multivariate analysis,results showed that hospital exposure was the only significant factor(OR=29.23,95%CI:2.82-302.89)for those babies younger than 8-months. Factors as hospital exposure and travelling among cities for 7-21 days before being infected,were with significant importance(OR=5.15,95%CI:2.28-11.63;OR=5.48,95%CI:1.38-21.69)for people ≥15 years of age,according to the observation from 74 cases and 222 controls. Conclusion In order to reduce the incidence of measles among babies under 8-month-old and people ≥15 years old, efforts on control of nosocomial infection should be strengthened,while the routine immunization coverage need to be increased for the children at higher risks,to reduce the source of infection.

Objective To investigate the role of Ki-67,c-myc,p53 in human in esophageal cancer.Methods 25 specimens of human esophageal cancer as observe group and 25 adjacent normal specimens as control group were selected.Expressions of Ki-67,c-myc,p53 protein were detected by immunohistochemical staining.Results Protein expressions levels of Ki-67,c-myc and p53 in human esophageal cancer were significantly higher than those in control group 5.0,2.0,3.0 vs 1.0,0.5,0.3,respectively (all P ＜ 0.05).The expression level of Ki-67 protein in high differentiation group were significantly lower than that of moderate and low differentiation group (3.0 vs 6.0,P ＜ 0.05).In human esophageal cancer specimens,the expression level of Ki-67 protein was positively correlated with that of c-myc (P ＜ 0.05).Conclusion The expressions of Ki-67,c-myc and p53 are higher in esophageal cancer,which are increased with the higher differentiation.Ki-67,c-myc and p53 proteins may be taken as potential markers in human esophageal cancer.

The correlation of single nucleotide polymorphism (SNP) rs10569304 on the second expressed region of hole gene and congenital heart disease (CHD) of human being, and the effect of hole gene on CHD were investigated. 179 patients with CHD as CHD group and 183 healthy people as control group were selected in the case-control study. DNA was abstracted from the peripheral blood by phenol-chloroform method. Primer was designed for the flanking sequence of SNP rs10569304 on the second expressed region of hole gene. The genotype was identified by PCR degenerative acrylamide electrophoresis with amplification products. Then the three amplification products received sequencing. By chi-square test, the genotype frequency and allele frequency in CHD group and control group were analyzed. There was insertion-deletion (GCC/-) of SNP rs10569304 which corresponded to alleles of A and B in Southern Chinese people. The genotype frequency and allele frequency in control group and CHD group were met the Hardy-Weinberg equilibrium. By chi-square test, in control group and CHD group, the genotype frequency of AA (insertion homozygous), AB (insertion-deletion heterozygous) and BB (deletion homozygous) was 21.31%, 54.09%, 24.59% and 16.75%, 46.36%, 36.87%, respectively. The distributional difference of genotype frequency had statistical significance (chi (2)=6.51, P<0.05); The allele frequency of A and B was 48.36% and 51.64% in control group, 39.94% and 60.06% in CHD group, respectively. The distributional difference of allele frequency had statistical significance (chi (2)=5.20, P<0.05). Meanwhile, by contrast with the control group, the BB genotype frequency and B allele frequency in CHD group was higher, but the AA and AB frequency was lower. There was higher risk to suffer from CHD involving B allele. BB genotype had 1.907-fold increased risk of developing CHD according to AA genotype (P<0.05). It is concluded that there is insertion-deletion (GCC/-) of SNP rs10569304 in the Southern Chinese people, and the people whose hole gene involving BB genotype have higher risk to suffering from CHD.