Objective:To explore the application value of patient data-based real-time quality control (PBRTQC) in enhancing the effectiveness of internal quality control (IQC) management.Methods:From the PBRTQC real-time quality control intelligent monitoring platform integrated with the laboratory information system (LIS), a total of 35,631 test results of red blood cell (RBC) count, white blood cell (WBC) count, and dehydroepiandrosterone sulfate (DHEA-S) were collected from patients of the Department of General Xi'an Area Medical Laboratory Center from August 1, 2023, to April 1, 2024. The platform was used in patient data distribution characteristics test, EWMA real-time quality control chart procedure establishment, performance validation, effect evaluation, best procedure selection, and real-time operation. The performance evaluation indexes of the best PBRTQC procedure establishment, the cut-off limit range, weighting coefficient, cumulative mean, standard deviation (SD), coefficient of variation ( CV) of the EWMA real-time quality control chart, and the cumulative mean, SD, and CV of its internal quality control data in the same period were counted, and at the same time compared with the quality target (1/3TEa). Coefficient of variation analyses were performed to compare the quality control status of PBRTQC and conventional internal quality control in the presence of warning or alarm prompts based on quality control process records, and alarm messages. Results:The evaluation indexes of the optimal procedures for RBC count, WBC count, and DHEA-S were the probability of error detection (Ped) between 93%-97% and greater than 90%, the false positive rate (FPR) between 0.0%-0.5%, the false negative rate (FNR) between 3.0%-7.0%, and the average number of the patient sample until error detection (ANPed) between 5-11, which is in line with the optimal quality control efficacy quality requirements for the PBRTQC procedure. The patient outcome cut-off concentrations for the optimal procedure EWMA quality control charts ranged from RBC count (3.92-5.16)×10 12/L, WBC count (4.28-7.50)×10 9/L, and DHEA-S (830-2 160) μg/L; (2 160-4 210) μg/L. The weighting coefficients were 0.05, 0.03, and 0.03, respectively. The real-world application of the EWMA real-time quality control charts showed stable and excellent analytical performance of the measurement system, such as out-of-control alarm: RBC count, 1 true alarm, Ped of 95.85%, and FPR of 0%. The cumulative CV of EWMA was less than the quality target; the cumulative CV of DHEA-S was 7.66% and 9.47%, respectively, and the cumulative CV of low level was greater than the quality target (8.33%), and the cumulative CV of high and low levels were 4.12% and 6.25%. Conclusion:The PBRTQC EWMA method can monitor the patient data - in real-time and continuous way. It can also dynamically identify and provide early indication of small changes in analytical performance during the analysis process, and can be used as a supplement to quality control products to improve the efficacy of laboratory quality management.

Objective To study the inner ear appearance on three-dimensional real inversion recovery(3D re-al IR)imaging in patients with sudden sensorineural hearing loss,and to investigate the relationship between blood-labyrinth barrier permeability and pathogenesis and prognosis of sudden hearing loss.Methods A total of 41 pa-tients with sudden sensorineural hearing loss received 3D real IR at 3.0 T MRI,and the signal intensity of inner ear were recorded.We respectively measured cochlear signal intensity in affected and healthy ears,and medullary signal intensity,and calculated the cochlear/medulla ratio(CM ratio)separately.On the basis of CM ratio,we evaluated hearing levels at initial and after treatment,and the relationship between CM ratio and hearing prognosis.Results Among the 41 patients,33 cases(occupying 80.48％)individually had a higher CM ratio in the affected ear than in the healthy one.The CM ratio of the affected side was not higher than that of the healthy side in 8 cases,and the ef-fective rate was 100％,eighteen cases had below 1.5 times the CM ratio in affected ears as in healthy ears,with 77.78％effective rate of treatment;seven cases had 1.5 to 1.75 times,with 100％effective rate;two cases had 1.75 to 2 times,with 50％effective rate;and the rest 14 cases had over 2 times,with 14.28％effective rate(P＜0.05).Conclusion The variation of blood-labyrinth barrier permeability in patients with sudden hearing loss can be read on the 3D Real IR,and it indicates that 80.48％patients have higher-intensity signals in lateral cochlea.The CM ratio can be adopted to evaluate the extent of inner ear damage of patients more accurately.As the CM ratio ri-ses,patients'prognosis become worse,and patients with over 1.75 times the CM ratio in the affected ear as in the healthy one,mostly suffer poor prognosis.

Objective:To explore the prognostic impact of different intracranial radiotherapy modalities in patients with a limited number (≤10) of brain metastases from small cell lung cancer (SCLC-BM).Methods:The data of 143 cases with SCLC-BM that received intracranial radiotherapy at the First Affiliated Hospital of Bengbu Medical University in 2019-2022 were analyzed. The patients were grouped by radiotherapy modalities: whole brain radiotherapy (WBRT, 58 cases), WBRT combined with simultaneous integrated boost (WBRT+ SIB, 53 cases), and WBRT combined with sequential integrated boost (WBRT+ SEB, 32 cases). The overall survival (OS) and intracranial progression-free survival (IPFS) were calculated using the Kaplan-Meier method, and the Cox proportional hazard model was used for prognostic analysis.Results:In the whole group, the median OS and IPFS were 11.9 and 9.9 months, and the 1-, 2-, and 3-year survival rates were 49.7%, 15.3%, and 2.9%, respectively. The difference in OS among patients in the WBRT+ SIB, WBRT+ SEB, and WBRT groups was not significant (median OS: 13.0 months vs. 12.5 months vs. 11.2 months, P>0.05). The WBRT+ SIB and WBRT+ SEB groups were preferred over the WBRT group in terms of IPFS (median IPFS: 11.7 months vs. 10.4 months vs. 8.1 months, χ2=21.69, P<0.001). For patients with few brain metastases (≤3) analyzed separately, the WBRT+ SIB and WBRT+ SEB groups were preferred over the WBRT group in terms of OS and IPFS (median OS: 14.4 months vs. 13.7 months vs. 11.5 months, χ2=8.72, P=0.013; median IPFS: 12.6 months vs. 10.4 months vs. 8.9 months, χ2=12.37, P=0.002). Evaluation of the central nervous system as well as hematological acute radiological reactions reaching grade 2 and above showed no significant differences among the three groups ( P>0.05). Multivariate analysis showed that subsequent chemotherapy, targeted therapy, and immunotherapy were common independent influencing factors for patients′ OS and IPFS. Body mass index (BMI) level was an independent influencing factor for patients′ OS, and the number of brain metastases, lymph node metastasis, and radiotherapy modality were independent influencing factors for patients′ IPFS. Conclusions:BMI level and subsequent treatment (chemotherapy, targeted therapy, and immunotherapy) are independent influencing factors for patients' prognosis. WBRT+ SIB and WBRT+ SEB modalities are associated with increased IPFS.

Objective To understand the timeliness of antiretroviral therapy (ART) in newly reported HIV/AIDS cases in Yichang from 2016 to 2022 and its influencing factors, and to provide a scientific basis for improving the timeliness of ART in Yichang City. Methods HIV/AIDS cases data from January 1, 2016 to December 31, 2022 were collected, and chi-square tests and logistic regression were used to analyze the factors influencing the timeliness of ART. Results A total of 1 126 HIV/AIDS cases were collected, with local reported cases accounting for 83.13%. The male to female ratio was 5.15:1. The median age was 42 years old (28-53 years old). 41.03% of the cases were unmarried. 38.99% of cases had a first-time CD4+T lymphocytes (CD4 cells) count < 200 cells/µL. Cases with timely first CD4 cell test accounted for 67.85%. The overall timely rate of ART from 2016 to 2022 was 57.19%, with a median time from diagnosis to initiation of ART of 20 days. There was no statistically significant difference in the trend of ART timely rate from 2016 to 2022 (P=0.251). Cases with timely first CD4 cell test were more likely to initiate ART in time (OR=3.831, 95% CI:2.454-5.981), while cases reported from other areas (OR=0.497, 95% CI:0.345-0.716) and cases with higher first CD4 cell count levels (OR_≥500=0.473, 95% CI:0.312-0.718) were less likely to initiate ART in time. Conclusion The timely rate of antiviral treatment in Yichang City needs to be further improved. High attention should be paid to cases reported from other places, cases with delayed CD4 cell testing, and cases with high CD4 cell count levels. Treatment mobilization and referral should be done well, and early detection services should be provided in time.

With the increasing incidence of cardiovascular diseases,Professor WANG Yongyan has adhered to the traditional principles while embracing innovation,proposing to apply the theory of"the heart governing the spirit"to the prevention and treatment of cardiovascular diseases.He emphasized that it is crucial to preserve the spirit before the onset of disease,which includes maintaining a balanced diet,regular lifestyle,avoiding excessive labor,maintaining a serene and unfettered mind,and nurturing the spirit within.For those already suffering from disease,preventing progression and deterioration requires adjusting the spirit,and skilled practitioners should first inspect the patient's spirit by examining the eyes,tongue,facial complexion,and overall physical condition.In treatment,adjusting the spirit involves distinguishing between different imbalances of qi,blood,yin,yang,cold,heat,deficiency,and excess,and employing appropriate method to calm and nourish the spirit accordingly.After the illness,nurturing the spirit is essential,including spiritual nourishment through exercise,dietary therapy,emotional therapy,and external treatments.By applying the theory of"the heart governing the spirit"throughout the prevention,treatment,and rehabilitation of cardiovascular diseases,Professor WANG Yongyan's approach effectively prevents the occurrence of cardiovascular diseases,controls their progression,inhibits deterioration,and improves the prognosis of patients.

Objective To analyze the epidemiological characteristics of syphilis in Yichang City from 2011 to 2020, and provide a scientific basis for developing effective control measures. Methods The data of syphilis cases reported in Yichang City from 2011 to 2020 were collected and analyzed by descriptive epidemiological methods. Results A total of 8 107 cases of syphilis were reported in Yichang City from 2011 to 2020, with an average annual reported incidence rate of 19.76 per 100 000.The reported incidence of syphilis increased from 17.39/100 000 in 2011 to 24.49/100 000 in 2018 （APC=6.82%，95%CI：2.34%~11.49%， P＜0.05）, from 24.49/100 000 in 2018 Decline to 17.55/100 000 in 2020（P＞0.05）. Recessive syphilis is the main type, with 5 837 cases (72.00%), and the annual reported incidence rate is 14.23 per 100 000. The number of cases peaked in July, at 836 (10.31%), and 433 (5.34%) of the lowest in February . The top 3 counties with annual average reported incidence rates were Zigui County (28.51/100 000) , Xiling District (25.01/100 000), and Dangyang City (23.73/100 000). There were a statistically significant differences in reported incidence between counties (2 =933.92, P＜0.01). Gender ratio was 0.72. Cases mainly concentrated in people over 20 years old, 7901 cases (97.46%). The occupation distribution is mainly farmers, housework, unemployed, and retired people. Conclusion The incidence of syphilis in Yichang City has been on the rise in recent ten years, and there is still a long way to go to prevent and control syphilis. We suggested to continue to strengthen the prevention and control of syphilis and comprehensively prevent and control the spread of syphilis.

Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with unclear etiology and limited treatment options. The median survival time for IPF patients is approximately 2-3 years and there is no effective intervention to treat IPF other than lung transplantation. As important components of lung tissue, endothelial cells (ECs) are associated with pulmonary diseases. However, the role of endothelial dysfunction in pulmonary fibrosis (PF) is incompletely understood. Sphingosine-1-phosphate receptor 1 (S1PR1) is a G protein-coupled receptor highly expressed in lung ECs. Its expression is markedly reduced in patients with IPF. Herein, we generated an endothelial-conditional S1pr1 knockout mouse model which exhibited inflammation and fibrosis with or without bleomycin (BLM) challenge. Selective activation of S1PR1 with an S1PR1 agonist, IMMH002, exerted a potent therapeutic effect in mice with bleomycin-induced fibrosis by protecting the integrity of the endothelial barrier. These results suggest that S1PR1 might be a promising drug target for IPF therapy.

Objective To provide reference for the development of prevention and control strategies for HIV/AIDS cases aged 50 and above in Yichang city from 2013 to 2020 by epidemiological characteristics anaylsing. Methods Descriptive epidemiological method was used to analyze the epidemic situation and epidemiological data. Results A total of 1 126 HIV/AIDS cases were reported during the monitoring period, and 296 cases were 50 years old and above, accounting for 26.29%. The proportion of cases aged 50 years and above to the total number of cases and the annual reported incidence rate both showed an upward trend (P＜0.01). The cases were mainly male (74.66%), and the older the age, the greater the proportion of males (P=0.02). The age of confirmed cases is mainly concentrated in 50-59 years (68.58%), of which 49.66% were married and 74.32% were at junior high school and below. Sexual contact (accounting for 99.66%) was the main route of infection, the proportion of non-marital heterosexual sex was relatively high, especially in female cases (accounting for 74.67%). Those who had been infected for more than 8 years accounted for 48.75%, and the proportion of infected age ≥50 years in the total number of cases showed an upward trend. Cases were found mainly from medical institutions (74.66%). Conclusion The HIV/AIDS epidemic situation of people aged 50 and above in Yichang City was relatively severe and has became a key population for prevention and control. Targeted and effective prevention and control measures should be taken to reduce the harm of AIDS to the population.

Objective:To report the results of a study of 7 patients with osteoarthritis who underwent arthroscopic sternoclavicular arthroplasty in response to conservative treatment.Methods:Arthroscopic sternoclavicular arthroplasty was performed in 7 patients with sternoclavicular osteoarthritis. There were 3 males and 4 females.The age ranges from 34 to 62, with an average age of 43. Patients were evaluated before surgery and at follow-up using the Constant score and Rockwood sternoclavicular joint score system. The postoperative follow-up lasted from 1 to 10 months, with an average of 3.7 months. The surgery was performed under general anesthesia without shoulder joint fixation.Results:All patients recovered preoperative function or full activity within 2 weeks after operation. At the last follow-up, 6 patients had no pain and 1 had mild tension after activity. The median Constant score increased from 69.6 (62-80) to 94.3 (88-96); The median Rockwood score increased from 5.7 (on a scale of 3 to 8) to 14.3 (on a scale of 12 to 15)(maximum 15). Clinical efficacy: All 7 cases were excellent (13-15 points). There were no complications, especially no problems with joint stability.Conclusion:Arthroscopic sternoclavicular arthroplasty is a new method for the treatment of sternoclavicular osteoarthritis which failed to respond to conservative treatment.

Objective:To analyze the changes in the epidemiological characteristics of scarlet fever cases in Shanghai City before and after the outbreak of coronavirus disease 2019 (COVID-19), and to provide a reference for scientific prevention and control of scarlet fever.Methods:The information of scarlet fever reported cases in Shanghai City from January 2016 to June 2021 in the information system of Chinese Disease Prevention and Control was collected, and the differences in time trend, regional distribution, age and gender distribution of cases before and after the outbreak of COVID-19 in Shanghai City were analyzed by descriptive epidemiologic method.Results:The incidence rate of scarlet fever reported in 2016-2019 was (0.22-4.02)/100 000 in each month, with a median of 1.13/100 000. During January 2020 (the outbreak began in Shanghai City) and June 2021, the incidence rate of scarlet fever was (0.01-1.64)/100 000, with a median of 0.14/100 000, which was 12.39% of that before the outbreak of COVID-19. During February and June 2020, the monthly reported incidence rate of scarlet fever was (0.18-0.58)/100 000, showing an upward trend compared with the same period in 2020 ((0.01-0.05)/100 000). From 2016 to 2019, the annual reported incidence rate of each district was (0.55-65.48)/100 000, with a median of 9.57/100 000; while in 2020, the annual reported incidence rate of each district was (0.29-9.85)/100 000, with a median of 2.18/100 000, which was 22.78% of that before the outbreak of COVID-19. The incidence of scarlet fever dropped significantly. The incidence rate in Minhang District was still the highest. The cases were mainly four to eight years old, and there was no substantial difference of the proportions before and after COVID-19 pandemic, with the incidence rate of six years old group the highest. The proportion of male was more than female in reported case, while the male ratio in reported cases was not significantly different before and after COVID-19 pandemic.Conclusions:The incidence rate of scarlet fever in Shanghai City has dropped sharply after COVID-19 pandemic. The main epidemiological characteristics of the regional and population distribution of cases remain unchanged.