To analyze all-cause mortality among hepatitis C cases aged ≥18 years in Yuxi City from 2005 to 2023 and explore the interactions of factors influencing survival time. Baseline and follow-up data for hepatitis C cases reported during this period were extracted from the Chinese National Notifiable Disease Reporting System. Survival time and related factors were assessed using the Cox proportional hazards model. Kaplan-Meier cumulative mortality risk curves were generated for treated and untreated hepatitis C cases, and interactions among subgroups of various influencing factors were examined. A total of 5 110 hepatitis C cases aged ≥18 years were reported from 2005 to 2023, encompassing 35 349.25 person-years of observation with the follow-up time duration M ( Q1, Q3) was 6.17 (2.33, 11.08) person-years. There were 763 all-cause deaths, corresponding to a mortality density of 2.16 per 100 person-years. Survival analysis showed a statistically significant difference in cumulative mortality between the treated and untreated groups (Log-rank χ2=122.033, P<0.001), with a lower risk of death observed among treated patients. Additive model analysis showed that there was a synergistic interaction between treatment status and age group, with relative excess of interaction, attributable proportions of interaction, and synergy index of 6.16 (95 %CI: 2.70-9.61), 1.83 (95 %CI: 1.46-2.30), and 0.42 (95 %CI: 0.31-0.53), respectively; and between treatment status and gender. There was a synergistic interaction between treatment status and sex, with relative excess of interaction, attributable proportions of interaction, and synergy index of 2.63 (95 %CI: 1.14-4.13), 1.56 (95 %CI: 1.19-2.06), and 0.32 (95 %CI: 0.17-0.46), respectively. The cause of death composition were 38.53% (249 cases) attributed to hepatitis C-related causes.The leading non-hepatitis C-related causes of death were cardiovascular and cerebrovascular diseases, pulmonary diseases, malignancies, drug overdose, and injuries. In conclusion, hepatitis C cases ≥18 years of age in Yuxi City had a lower cumulative mortality rate when treated than when untreated. Treatment status interacted with age and gender on patient survival, respectively. Changes in patients with concomitant cardiovascular diseases, pulmonary diseases and malignancies should be focused.

OBJECTIVE To analyze occupational exposure to sharps injuries among medical staff in different posi-tions in a three-A hospital.METHODS A retrospective collection of all sharps injury cases reported from 2018 to 2023 in a general hospital was conducted.The basic characteristics,high-risk links,involved instruments,post-exposure emergency treatment and follow-up situations were analyzed,while sharps injury characteristics of medi-cal staff in different positions were classified and discussed.RESULTS Over six years,340 sharps injuries occurred with the highest incidence among interns(2.70 cases/100 FTE·year)and the lowest among logistics staff(1.05 cases/100 FTE·year).Jun.was the month with the highest incidence,averaging 7.33 cases.High-risk links in-cluded instruments handling,placing instruments into sharp containers and removing needles from rubber or other barriers,accounting for 76.47%.Nurses experienced injuries mostly occurred in general wards and were related to scalp needles;doctors mostly occurred in operating rooms and were due to surgical instruments;interns were pri-marily injured by blood collection needles;pharmacists and medical technicians were related to ampoule handling;while logistical staff were mostly injured by hollow needles and glass fragments from waste disposal.Nurses and doctors were the main injured groups,with a higher incidence among females(25-<35 years)and males(less than five years of work experience).The exposure source was mainly hepatitis B virus(HBV)infection.Post-ex-posure treatment was primarily standardized emergency treatment,but a higher proportion of non-standardized treatment was observed among logistics staff.Follow-up reports showed that interns and logistical staff had lower submission rates and lower training coverage.CONCLUSIONS Significant differences exist in sharps injury charac-teristics among medical staff in different positions.Attention should be paid to position-specific high-risk links and instruments.Targeted training and occupational health management should be strengthened to effectively prevent occupational exposure.

AIM To establish LC-MS and GC-MS method and analyze the chemical constituents of Dendrobium huoshanense C.Z.Tang & S.J.Cheng flowers.METHODS LC-MS was performed on a Zorbax Eclipse C18 column(2.1 mm×100 mm,1.8 μm),with the mobile phase comprising of water(containing 0.1％formic acid)-acetonitrile flowing at 0.3 mL/min,and electrospray ionization was operated in both positive and negative ion modes.The GC-MS employed headspace solid-phase microextraction for sample preparation,and the analysis was performed on an HP-5MS column(30 m×0.25 mm,0.25 μm),with the following temperature program:initial temperature 50 ℃(held for 2 min),increased at 5 ℃/min to 180 ℃(held for 5 min),then raised at 10 ℃/min to 250 ℃(held for 5 min),and electron impact ion source was employed.RESULTS A total of 62 compounds were identified by LC-MS,including 35 flavonoids,4 coumarins,6 alkaloids,6 terpenoids,3 amino acids,2 polyphenols,2 ketones and 4 others.A total of 101 volatile components were identified by GC-MS,including ketones,aldehydes,alcohols,esters,ethers,and acid.CONCLUSION This method can comprehensively analyze the chemical constituents of D.huoshanense flowers,and provide a scientific basis for elucidating its pharmacodynamic material basis.

Objective To investigate the clinical value of serum hsa_circRNA_0002980 and hsa_circRNA_104348 expression in the diagnosis and prognosis evaluation of liver cancer patients.Methods From April 2020 to April 2022,a total of 105 liver cancer patients and 105 liver cirrhosis patients admitted in the hospital were selected as the liver cancer group and cirrhosis group,and another 105 healthy volunteers who underwent physical examinations in the hospital were selected as the control group.Real-time fluorescence quantitative PCR(qPCR)was applied to detect the expression of serum hsa_circRNA_0002980 and hsa_circRNA_104348.Receiver operating characteristic(ROC)curve was applied to evaluate the diagnostic value and prognostic val-ue of serum hsa_circRNA_0002980 and hsa_circRNA_104348 expression in liver cancer.Multivariate COX re-gression was performed to analyze the influencing factors of prognosis in liver cancer.Results The expression levels of serum hsa_circRNA_0002980 in the liver cancer group,liver cirrhosis group,and control group in-creased sequentially(P＜0.05),while the expression levels of serum hsa_circRNA_104348 decreased sequen-tially(P＜0.05).The levels of alanine aminotransferase and aspartate aminotransferase in the liver cancer group and the liver cirrhosis group were higher than those in the control group(P＜0.05),and the level of al-bumin was lower than that in the control group(P＜0.05).The area under the curve(AUC)for the diagnosis of liver cancer by hsa_circRNA_0002980 combined with hsa_circRNA_104348 was 0.888(95％CI:0.838-0.928),which was obviously higher than those of hsa_circRNA_0002980(Z=3.526,P＜0.001)and hsa_cir-cRNA_104348 alone(Z=2.184,P=0.029).The expression level of serum hsa_circRNA_0002980 in the poor prognosis group was lower than that in the good prognosis group(P＜0.05),and the expression level of ser-um hsa_circRNA_104348 and the proportion of TNM stage Ⅲ+Ⅳ were higher than those in the good progno-sis group(P＜0.05).The AUC for predicting prognosis in liver cancer patients by the combination of hsa_cir-cRNA_0002980 and hsa_circRNA_104348 was 0.870(95％CI:0.790-0.928),and there was no statistically significant difference compared to the AUC predicted separately by hsa_circRNA_0002980 and hsa_circRNA_104348(P＞0.05).The expression of serum hsa_circRNA_0002980,hsa_circRNA_104348 and TNM stage were influencing factors for the prognosis of liver cancer patients(P＜0.05).Conclusion The expression lev-el of hsa_circRNA_0002980 in the serum of liver cancer patients is relatively low,while the expression level of hsa_circRNA_104348 is relatively high.Both have certain clinical significance in the diagnosis and prognosis e-valuation of liver cancer.

This study retrospectively reviewed the clinical data of 9 recipients with post-transplant lymphoproliferative disorder (PTLD) after liver transplantation admitted to the Organ Transplantation Center of the Affiliated Hospital of Qingdao University from January 2020 to June 2024, and summarized their clinical manifestations, pathological features, treatment regimens, and prognostic conditions, so as to provide a reference for clinical diagnosis and treatment.

To analyze all-cause mortality among hepatitis C cases aged ≥18 years in Yuxi City from 2005 to 2023 and explore the interactions of factors influencing survival time. Baseline and follow-up data for hepatitis C cases reported during this period were extracted from the Chinese National Notifiable Disease Reporting System. Survival time and related factors were assessed using the Cox proportional hazards model. Kaplan-Meier cumulative mortality risk curves were generated for treated and untreated hepatitis C cases, and interactions among subgroups of various influencing factors were examined. A total of 5 110 hepatitis C cases aged ≥18 years were reported from 2005 to 2023, encompassing 35 349.25 person-years of observation with the follow-up time duration M ( Q1, Q3) was 6.17 (2.33, 11.08) person-years. There were 763 all-cause deaths, corresponding to a mortality density of 2.16 per 100 person-years. Survival analysis showed a statistically significant difference in cumulative mortality between the treated and untreated groups (Log-rank χ2=122.033, P<0.001), with a lower risk of death observed among treated patients. Additive model analysis showed that there was a synergistic interaction between treatment status and age group, with relative excess of interaction, attributable proportions of interaction, and synergy index of 6.16 (95 %CI: 2.70-9.61), 1.83 (95 %CI: 1.46-2.30), and 0.42 (95 %CI: 0.31-0.53), respectively; and between treatment status and gender. There was a synergistic interaction between treatment status and sex, with relative excess of interaction, attributable proportions of interaction, and synergy index of 2.63 (95 %CI: 1.14-4.13), 1.56 (95 %CI: 1.19-2.06), and 0.32 (95 %CI: 0.17-0.46), respectively. The cause of death composition were 38.53% (249 cases) attributed to hepatitis C-related causes.The leading non-hepatitis C-related causes of death were cardiovascular and cerebrovascular diseases, pulmonary diseases, malignancies, drug overdose, and injuries. In conclusion, hepatitis C cases ≥18 years of age in Yuxi City had a lower cumulative mortality rate when treated than when untreated. Treatment status interacted with age and gender on patient survival, respectively. Changes in patients with concomitant cardiovascular diseases, pulmonary diseases and malignancies should be focused.

This study retrospectively reviewed the clinical data of 9 recipients with post-transplant lymphoproliferative disorder (PTLD) after liver transplantation admitted to the Organ Transplantation Center of the Affiliated Hospital of Qingdao University from January 2020 to June 2024, and summarized their clinical manifestations, pathological features, treatment regimens, and prognostic conditions, so as to provide a reference for clinical diagnosis and treatment.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective:To apply artificial intelligence（AI）in classifying ovarian tumors on ultrasound images，and compare the diagnostic results of several sonographers with varying seniority levels.Methods:A total of 645 patients diagnosed with adnexal masses via gynecological ultrasound examination at Qilu Hospital of Shandong University from January 2021 to December 2024 were enrolled. Three deep learning architectures，i.e.，Alexnet，Densenet121，and Resnet50 were developed and used to internally test the classification effectiveness of ovarian tumors，while the optimal model was selected for external testing. Two junior sonographers and two senior sonographers were recruited to independently diagnose ovarian tumors in the external test dataset. Subsequently，the benign and malignant results of the model's predictions were disclosed to each sonographer，and their revised diagnoses on the same external test data in combination with the best AI model were recorded.Results:The optimal model achieved an accuracy of 0.941，sensitivity of 0.936，and specificity of 0.944 on the internal test dataset，and maintained robust performance on the external test dataset with accuracy of 0.891，sensitivity of 0.880，and specificity of 0.907. Compared to junior sonographers，the optimal model demonstrated significantly higher sensitivity in discriminating benign from malignant ovarian tumors（0.880 vs. 0.723，0.602；all P<0.05）. No statistically significant difference was observed in diagnostic accuracy between the optimal model and senior sonographer 1（ P=0.05）. With assistance from the optimal model，junior sonographers achieved significant improvements in both sensitivity and specificity（sensitivity：0.723 vs. 0.843，0.602 vs. 0.819；specificity：0.778 vs. 0.833，0.685 vs. 0.741；all P<0.05）. Conclusions:The optimal model achieves comparable performance to that of senior sonographers in ovarian tumor classification. With model assistance，the diagnostic performance of junior sonographers is significantly improved.

OBJECTIVE To analyze occupational exposure to sharps injuries among medical staff in different posi-tions in a three-A hospital.METHODS A retrospective collection of all sharps injury cases reported from 2018 to 2023 in a general hospital was conducted.The basic characteristics,high-risk links,involved instruments,post-exposure emergency treatment and follow-up situations were analyzed,while sharps injury characteristics of medi-cal staff in different positions were classified and discussed.RESULTS Over six years,340 sharps injuries occurred with the highest incidence among interns(2.70 cases/100 FTE·year)and the lowest among logistics staff(1.05 cases/100 FTE·year).Jun.was the month with the highest incidence,averaging 7.33 cases.High-risk links in-cluded instruments handling,placing instruments into sharp containers and removing needles from rubber or other barriers,accounting for 76.47%.Nurses experienced injuries mostly occurred in general wards and were related to scalp needles;doctors mostly occurred in operating rooms and were due to surgical instruments;interns were pri-marily injured by blood collection needles;pharmacists and medical technicians were related to ampoule handling;while logistical staff were mostly injured by hollow needles and glass fragments from waste disposal.Nurses and doctors were the main injured groups,with a higher incidence among females(25-<35 years)and males(less than five years of work experience).The exposure source was mainly hepatitis B virus(HBV)infection.Post-ex-posure treatment was primarily standardized emergency treatment,but a higher proportion of non-standardized treatment was observed among logistics staff.Follow-up reports showed that interns and logistical staff had lower submission rates and lower training coverage.CONCLUSIONS Significant differences exist in sharps injury charac-teristics among medical staff in different positions.Attention should be paid to position-specific high-risk links and instruments.Targeted training and occupational health management should be strengthened to effectively prevent occupational exposure.