Objective Healthcare-associated infection(HAI)outbreak events pose significant threat to healthcare system.This paper aims to provide a new perspective to explain the causal pathways of HAI outbreak events and seek effective prevention and control strategies.Methods Cases of HAI outbreak events were collected by literature review.Interaction among risk factors was explored through crisp-set qualitative comparative analysis(csQCA).Results Inadequate procedures such as disinfection,isolation,hand hygiene,and management system,as well as improper use of antimicrobial agents,invasive procedures,and low immune function of patients were the antece-dents of HAI outbreak events.Configuration analysis reveals that there were four pathways between HAI outbreak events and risk factors,and could be classified into two types:the isolation-management synergistic type and multi-factor co-promotion type.Conclusion Prevention and control of HAI outbreak requires coordinated effect of per-sonnel isolation(including isolation of patients and protection of healthcare workers)and management,proper disin-fection and isolation,and rational use of antimicrobial agents,so as to prevent infection outbreaks caused by the combination of risk factors.

Objective Healthcare-associated infection(HAI)outbreak events pose significant threat to healthcare system.This paper aims to provide a new perspective to explain the causal pathways of HAI outbreak events and seek effective prevention and control strategies.Methods Cases of HAI outbreak events were collected by literature review.Interaction among risk factors was explored through crisp-set qualitative comparative analysis(csQCA).Results Inadequate procedures such as disinfection,isolation,hand hygiene,and management system,as well as improper use of antimicrobial agents,invasive procedures,and low immune function of patients were the antece-dents of HAI outbreak events.Configuration analysis reveals that there were four pathways between HAI outbreak events and risk factors,and could be classified into two types:the isolation-management synergistic type and multi-factor co-promotion type.Conclusion Prevention and control of HAI outbreak requires coordinated effect of per-sonnel isolation(including isolation of patients and protection of healthcare workers)and management,proper disin-fection and isolation,and rational use of antimicrobial agents,so as to prevent infection outbreaks caused by the combination of risk factors.

Objective:To identify the risk factors of venous thromboembolism (VTE) in postoperative renal transplantation recipients by Meta-analysis, and to provide evidence-based reference for clinical staff to develop early VTE prevention strategies.Methods:PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, VIP database, Wanfang database and Chinese Biomedical Literature Database were searched to collect the studies on the risk factors of postoperative VTE in kidney transplant recipients. The search period was from the establishment of the database to March 10, 2024. After literature screening, data extraction and quality evaluation were conducted independently by two researchers, Meta-analysis was performed using RevMan 5.3 software.Results:A total of 15 literatures with 20 influencing factors were included. Meta-analysis showed that age ( MD = 6.36, 95% CI 2.56-10.17, P<0.05), body mass index ( MD = 1.83, 95% CI 0.15-3.50, P<0.05), VTE history ( OR = 2.04, 95% CI 1.08-3.86, P<0.05), blood transfusion history ( OR = 3.77, 95% CI 2.43-5.83, P<0.05), glomerular filtration rate ( MD = -5.54, 95% CI -9.93 - -0.91, P<0.05), donor age ( MD = 3.18, 95% CI 1.10-5.25, P<0.05), combination of malignant tumor ( OR = 2.87, 95% CI 1.45-5.68, P<0.05), end-stage renal disease as polycystic kidney disease ( OR = 1.76, 95% CI 1.39-2.22, P<0.05), and interstitial nephritis ( OR = 1.60, 95% CI 1.06-2.40, P<0.05) were the influencing factors for postoperative VTE in renal transplant recipients. Conclusions:Clinical medical staff should actively identify high-risk groups for VTE after kidney transplantation by considering the 8 influencing factors determined by this study, and take targeted measures early to reduce the risk of postoperative VTE.

Objective:To identify the risk factors of venous thromboembolism (VTE) in postoperative renal transplantation recipients by Meta-analysis, and to provide evidence-based reference for clinical staff to develop early VTE prevention strategies.Methods:PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, VIP database, Wanfang database and Chinese Biomedical Literature Database were searched to collect the studies on the risk factors of postoperative VTE in kidney transplant recipients. The search period was from the establishment of the database to March 10, 2024. After literature screening, data extraction and quality evaluation were conducted independently by two researchers, Meta-analysis was performed using RevMan 5.3 software.Results:A total of 15 literatures with 20 influencing factors were included. Meta-analysis showed that age ( MD = 6.36, 95% CI 2.56-10.17, P<0.05), body mass index ( MD = 1.83, 95% CI 0.15-3.50, P<0.05), VTE history ( OR = 2.04, 95% CI 1.08-3.86, P<0.05), blood transfusion history ( OR = 3.77, 95% CI 2.43-5.83, P<0.05), glomerular filtration rate ( MD = -5.54, 95% CI -9.93 - -0.91, P<0.05), donor age ( MD = 3.18, 95% CI 1.10-5.25, P<0.05), combination of malignant tumor ( OR = 2.87, 95% CI 1.45-5.68, P<0.05), end-stage renal disease as polycystic kidney disease ( OR = 1.76, 95% CI 1.39-2.22, P<0.05), and interstitial nephritis ( OR = 1.60, 95% CI 1.06-2.40, P<0.05) were the influencing factors for postoperative VTE in renal transplant recipients. Conclusions:Clinical medical staff should actively identify high-risk groups for VTE after kidney transplantation by considering the 8 influencing factors determined by this study, and take targeted measures early to reduce the risk of postoperative VTE.

Stevens-Johnson syndrome (SJS), also known as the multifactorial erythematous drug eruption, is a class of adverse reactions of the skin and mucous membranes primarily caused by drug allergy often involving the oral cavity, eyes, and external genital mucosa, generally accompanied by fever, and can be life-threatening in severe cases. In February 2022, the Department of Stomatology, the First Affiliated Hospital of Zhengzhou University admitted a patient with huge inflammatory hyperplasia of bilateral lingual margins secondary to SJS. Upon admission, no other obvious symptoms were observed except for tongue hyperplasia. The patient suffered from a severe adverse drug reaction caused by acetaminophen 2 months ago and was complicated by liver dysfunction and pulmonary infection. After 1 month of treatment and rehabilitation, he developed a secondary tongue mass and was subsequently admitted to Dept. of Oral and Maxillofacial Surgery Ward 2, the First Affiliated Hospital of Zhengzhou University. After completing the examination, the tongue mass was surgically removed. After a follow-up of 11 months, the patient's condition was satisfactory and no temporary discomfort was observed. The case of tongue mass secondary to SJS is extremely rare. If a stomatologist encounters a similar case, we should carefully inquire about the drug allergy history and recent medication history, and be alert to whether or not they had adverse drug reactions recently.
Male ; Humans ; Stevens-Johnson Syndrome/drug therapy* ; Hyperplasia/pathology* ; Skin ; Drug Hypersensitivity/pathology* ; Tongue

Objective To explore the clinical applicability of diffusion kurtosis imaging (DKI)in children with spastic hemiplegic cerebral palsy.Methods 22 children with spastic hemiplegic cerebral palsy and age-matched 22 normal children were selected in this study,and were treated with routine brain MRI and DKI to test the white matter area of tractus corticospinalis on brainstem plane, anterior limb of internal capsule,posterior limb of inter capsule,genu of corpus callosum and the splenium of corpus callosum.The fractional alanisotropy(FA)value and mean kurtosis (MK)value of deep gray nuclei area in thalamus,lenticular nucleus and head of caudate nucleus were examined.Furthermore,gross motor function classification system (GMFCS)was performed for the children in research group.Two independent sample t test was applied in the comparison of groups.The correlation between DKI parameters and cerebral palsy gross motor function was analyzed by Spearman analysis.Results As for MK value,there were statistically significant differences in all different brain areas between the research group and the control group(P<0.05).And for FA value,there was statistically significant difference only in white matter area between the research group and the control group (P<0.05).However,there was no statistically significant difference in cerebral deep gray nuclei area (P>0.05).The GMFCS score was negatively correlated with the FA value,and was positively correlated with the MK value.Conclusion DKI can reflect the damaged situation of gray matter in children with cerebral palsy,and its parameter values can be used to monitor the children with cerebral palsy as evaluation indicators.

Objective Promote the development of disciplines and enforce the construction and training of talent echelon through selection and assessment of discipline and academy leaders.Methods Conduct classified management on different disciplines and academy leaders concerning theirworking positions.The specific measurements include setting up selection and evaluation systems separately with different focuses,implementing dynamic management,establishing performance oriented mechanisms of promotion and demotion during the tenure period.Results The construction of talent echelon plays a significant role in capacity building of young talents,team building and development of all disciplines.Conclusions Systematic measurements could promote the development of disciplines and cultivation of reserved talents,including attaching importance on talent echelon establishment,defining suitable function of hospital,strengthening talent team building;establish a well-functioning talent management mechanism and effective incentive mechanisms.

Objective To investigate the incidence,bacterial pathogen and risk factors of bacterial meningitis after major craniotomy.Methods Clinical data of patients who underwent at least one craniotomy in Huashan Hospital Affiliated to Fudan University in 2008 were collected.All subjects were ≥ 18 years old,and survived at least 7 days after surgery.Patients with only cerebrospinal fluid drainage,burr holes,cranioplasty,vascular interventional surgery,transsphenoidal or spinal surgery were excluded.Risk factors for bacterial meningitis after major craniotomy were analyzed by Logistic regression.Results A total of 691 patients were enrolled,in 60 of whom (8.68％) bacterial meningitis was identified.Among 44 samples,5 were positive in culture with 2 of Acinetobacter baumannii,1 of Enterococcus faecalis,1 of Streptococcus intermedius and 1 of Klebsiella pneumonia.Diabetes (OR =5.79,95％ CI:1.40-23.93,P =0.02),Glasgow Coma Scale score ＜ 12 (OR =6.56,95％ CI:1.17-36.80,P =0.03),external ventricular drainage (OR =4.31,95％ CI:1.57-11.82,P =0.01),and continuous lumbar cistern drainage (OR =22.82,95％ CI:10.31-50.52,P =0.00) were independent risk factors for bacterial meningitis after major craniotomy.Patients with external ventricular drainage ＞ 7 d were 11.82 times more likely to develop bacterial meningitis,and those with continuous lumbar cistern drainage ＞ 10 d were 25.50 times more likely to develop bacterial meningitis.Conclusions Bacterial meningitis remains a common complication after major craniotomy,and most are induced by Gram-negative bacilli.Diabetes,Glasgow Coma Scale score,external ventricular drainage and continuous lumbar cistern drainage may increase its incidence.

ObjectiveTo explore puncture point and angle of skin for unipedicular vertebroplasty by imaging measurement and combining clinical practice in order to pr vide reference for clinical work.MethodsCT images of thoracic and lumbar vertebrae of imaged with multislice helical CT were random chosen.From high to low position vertebrae of easy fracture T6 to -L5,its angle between vertebraI pedfcle stalk line and 1/3 of vertebraI body stalk line fore and median of point of intersection was measured.The angle of sternocostal joints route was also measured.At the same time the distance between site of skin puncture and spinous process was measured.ResultsThe angle between the thoracic vertebraI pedicle and sagittal section was (28.2 ± 3.8) °,the lateral distance of the spinous process was ( 31.6 ± 5.4) mm.The angle of thoracic vertebraI pedicle lateral route was (35 ± 3.4) °,the distance was ( 55.2 ± 5.3 ) mm.In the lumbar vertebrae pedicle route,the angle of L1 -L4 was (29.3 ± 5.6 ) °,the distance was (38.4 ± 4.5 )mm.Ls was (39.2 ± 3.3) °,the distance was ( 71.6 ± 6.2) mm.Combining clinical practice,the lateral distance of the spinous process in thoracic vertebraIpedicle route,the best puncture point was 30 mm,in thoracic vertebraI pedicle lateral route it was 40 mm,in L1-L4 it was 45 mm,in L5 it was 60 mm.ConclusionsThe unipedicular vertebroplasty can be performed rapidly,accurately and safely,and it reduces complications,cost and time.

A comparative observation about histological and histochemical study were made onthe preservating methods of local ischemic kidney of dogs.The methods of this exp-eriment were divided into five groups:A.Local hypothermia;B.Hypothermic perfu-sion solution 500ml,4℃,containing Procaine 450 mg and Heparin 100 mg,infusedinto renal artery;C.Hypothermic perfusion solution 500ml,4℃,containing 20% Ma-nniton 32ml,25% MgSO_4 0.36 ml,Heparin 100 ml,infused into renal artery;D.Localhypothermia and heparin 30 mg injected into the same vessel.E.Local room tem-perature.The specimens were taken from the kidneys of the experimental dogs atvarious period after treated with every method.The results were as follows;A,D and E group presented irreversible histological changes within 4 hoursaftertreatment.Four hours later,the reaction of SDH,ATPase,AlPase werenegative.It suggested that the kidney damage was serious,as well as expressed thatthe effect of these preservating methods for ischemic kidney are not satisfactory.In B group,the histological and histochemical alteration is very light and almostreversible,during 60 days after treatment.In C group,hypothermic perfusionsolution containing Mannitol,MgSO_4 etc either during experiment or follow observa-tion for 60 days,no histological and histochemical alterations were found.It indica-ted that this method is an ideal perservating technique for ischemic kidney.