Objective:To assess the impact of vaporized hydrogen peroxide (VHP) on the terminal decontamination effectiveness following the spillage of infectious materials in a BSL-3 laboratory.Methods:Within BSL-3 laboratories with volumes of 92.5 m 3 and 218 m 3, two types of Geobacillus stearothermophilus spore strips were used as biological indicators. ATCC7953 was affixed to stainless steel strips, while ATCC12980 was applied to paper strips. The strips were soaked in cell culture medium and chicken embryo egg fluid to simulate minor spill models. While strips continuously immersed in cell culture medium or chicken embryo egg fluid served as major spill models. These were compared against untreated biological indicator strips to evaluate the terminal decontamination efficacy of VHP. Results:After the completion of terminal disinfection, in laboratories of different volumes and at various sampling points, the culture result of both types of bacterial strips from the minor spill models and the untreated control strips were all negative. In the major spill models, the positivity rate of the two types of bacterial strips soaked in cell culture medium was 75%, while the positivity rate of the two types of bacterial strips soaked in chicken embryo egg fluid was 100%.Conclusions:In the event of a large spill of infectious materials in a laboratory, to ensure biosafety, it is recommended to first treat the spilled materials before initiating the terminal disinfection process. Additionally, under the same disinfection conditions, the material of the biological indicator strips does not affect the terminal disinfection outcomes.

Objective:To establish a rapid and accurate duplex real-time fluorescent reverse transcription-recombinase polymerase amplification/recombinase-aided amplification（RT-RPA/RAA）detection method for identification and differentiation of Nipah virus（NiV），Langya virus（LayV），Mojiang virus（MoJV），and Cedar virus（CedV）.Methods:First，specific primers and probes were designed targeting the conserved L gene regions of NiV and LayV，as well as the conserved N gene regions of MoJV and CedV，respectively. The four viruses were divided into two groups for duplex detection. Subsequently，the optimal primer and probe combinations were screened by comparing the amplification efficiency of different primer pair combinations（F1/R1，F1/R2，F2/R1，F2/R2）. The reaction temperature was optimized through temperature gradient settings from 37 ℃ to 42 ℃，and the amounts of primers and probes were optimized to establish the duplex real-time fluorescent RT-RPA/RAA detection system. Finally，the detection performance was evaluated through specificity，sensitivity，and stability tests，as well as clinical sample validation.Results:The selected primer pairs（NiV primer pair F2/R1，LayV primer pair F1/R1，MoJV primer pair F2/R2，and CedV primer pair F2/R2）all demonstrated optimal amplification efficiency when combined with their corresponding probes. The optimal annealing temperature was 39 ℃，and the minimum detection limit was 101-102 copies/μl. The method could effectively distinguish target viruses from other non-target viruses，and repeated experiments showed good stability（ R2> 0.90）. Additionally，detection results for Malaysian NiV strains and various clinical samples were consistent with the Taqman multiplex qRT-PCR method. Conclusion:The duplex real-time fluorescent RT-RPA/RAA detection method successfully established in this study can rapidly and accurately identify and differentiate four important henipavirus-like viruses：NiV，LayV，MoJV，and CedV. It features simple operation，rapid reaction，high specificity，and good stability，providing an effective molecular detection tool for rapid field diagnosis，surveillance，and control of these zoonotic viruses.

The statement"Blood is the material carrier of spirit and qi"indicates that the generation of blood relies on the coordinated governance of spirit and qi,while simultaneously serving as their material foundation.Based on the physiological connection among"blood-spirit-qi",this article explores the pathogenesis of premature ovarian insufficiency(POI)accompanied by anxiety and depression.It proposes that essence and blood deficiency,premature exhaustion of Tian Gui(reproductive essence),and failure of blood to nourish the spirit form a pathological chain:"blood deficiency-spirit disturbance-POI with anxiety and depression".Blood stasis obstructing the uterine chamber,disorder of the chong and ren meridians,and failure of blood to carry the spirit give rise to the transformation:"blood stasis-spirit depression-POI with anxiety and depression".Liver qi stagnation and disruption of qi and blood further exacerbate the imbalance between blood and spirit,aggravating the disease progression.Based on this pathological analysis,the general treatment principle of"regulating blood,harmonizing spirit,and rectifying qi"is established.For patients with blood deficiency syndrome,treatment should focus on tonifying essence and blood,replenishing reproductive essence,and nourishing the spirit,selecting Guanyuan(CV4),Zusanli(ST36),and Sanyinjiao(SP6)as main acupoints.For patients with blood stasis syndrome,treatment should aim to regulate the chong and ren meridians,promote blood circulation,and calm the spirit,selecting Qichong(ST30),Zhongji(CV3),and Xuehai(SP10)as main acupoints.Simultaneously,the method of regulating the liver should be applied throughout the entire treatment process to soothe the liver,regulate qi,relieve depression,and calm the spirit,selecting Baihui(GV20),Taichong(LR3),and Ganshu(BL18)as main acupoints.Appropriate acupuncture techniques and methods should be chosen according to the patient's constitution and condition,providing new therapeutic ideas and approaches for clinical practice.

Objective:To investigate the current situation of depressive symptoms, effort-reward imbalance (ERI), and sleep quality among train drivers, explore the interaction mechanism between various factors and depressive symptoms, and provide a certain theoretical basis for reducing the level of depressive symptoms among train drivers.Methods:From January to December 2022, train drivers were selected as the research subjects from the locomotive depot of a certain railway bureau through cluster sampling, with a total of 1392 people. A questionnaire survey was conducted to assess the basic situation, ERI, sleep quality and depressive symptoms of train drivers. Multiple stepwise regression was used to analyze the effects of each dimension of ERI and sleep quality on depressive symptoms, and binary logistic regression was used to analyze the effects of ERI and sleep quality on depressive symptoms.Results:Among 1392 train drivers, 897 (64.4%) were classified as having depressive symptoms. The results of multiple stepwise regression analysis showed that the dimensions of external effort, reward and overcommitment of ERI explained 10.3% of the variation in depressive symptoms ( P<0.01). Sleep quality explained 9.9% of the variation in depressive symptoms ( P< 0.01). The results of binary logistic regression analysis showed that after adjusting for confounding variables such as age, length of service, and educational level, high external effort ( OR=2.22, 95% CI: 1.76-2.79) and high overcommitment ( OR=1.90, 95% CI: 1.50-2.39) and poor sleep quality ( OR=5.82, 95% CI: 4.52-7.49) increased the risk of depressive symptoms for train drivers ( P<0.01), while reward was a protective factor for depressive symptoms ( OR=0.44, 95% CI: 0.35-0.55, P<0.01). In the ERI model, high effort and low reward was the greatest risk factor for depressive symptoms ( OR=4.77, 95% CI: 3.41-6.69, P<0.01). In the interaction between ERI and sleep quality, high ERI and poor sleep quality had the greatest negative impact on depressive symptoms ( OR=15.90, 95% CI: 7.27-34.76, P<0.01) . Conclusion:The influence of ERI on depressive symptoms of train drivers has both direct and indirect effects, and sleep quality plays a partial mediating role in the influence of ERI on depressive symptoms.

Objective:To assess the impact of vaporized hydrogen peroxide (VHP) on the terminal decontamination effectiveness following the spillage of infectious materials in a BSL-3 laboratory.Methods:Within BSL-3 laboratories with volumes of 92.5 m 3 and 218 m 3, two types of Geobacillus stearothermophilus spore strips were used as biological indicators. ATCC7953 was affixed to stainless steel strips, while ATCC12980 was applied to paper strips. The strips were soaked in cell culture medium and chicken embryo egg fluid to simulate minor spill models. While strips continuously immersed in cell culture medium or chicken embryo egg fluid served as major spill models. These were compared against untreated biological indicator strips to evaluate the terminal decontamination efficacy of VHP. Results:After the completion of terminal disinfection, in laboratories of different volumes and at various sampling points, the culture result of both types of bacterial strips from the minor spill models and the untreated control strips were all negative. In the major spill models, the positivity rate of the two types of bacterial strips soaked in cell culture medium was 75%, while the positivity rate of the two types of bacterial strips soaked in chicken embryo egg fluid was 100%.Conclusions:In the event of a large spill of infectious materials in a laboratory, to ensure biosafety, it is recommended to first treat the spilled materials before initiating the terminal disinfection process. Additionally, under the same disinfection conditions, the material of the biological indicator strips does not affect the terminal disinfection outcomes.

Objective:To establish a rapid and accurate duplex real-time fluorescent reverse transcription-recombinase polymerase amplification/recombinase-aided amplification（RT-RPA/RAA）detection method for identification and differentiation of Nipah virus（NiV），Langya virus（LayV），Mojiang virus（MoJV），and Cedar virus（CedV）.Methods:First，specific primers and probes were designed targeting the conserved L gene regions of NiV and LayV，as well as the conserved N gene regions of MoJV and CedV，respectively. The four viruses were divided into two groups for duplex detection. Subsequently，the optimal primer and probe combinations were screened by comparing the amplification efficiency of different primer pair combinations（F1/R1，F1/R2，F2/R1，F2/R2）. The reaction temperature was optimized through temperature gradient settings from 37 ℃ to 42 ℃，and the amounts of primers and probes were optimized to establish the duplex real-time fluorescent RT-RPA/RAA detection system. Finally，the detection performance was evaluated through specificity，sensitivity，and stability tests，as well as clinical sample validation.Results:The selected primer pairs（NiV primer pair F2/R1，LayV primer pair F1/R1，MoJV primer pair F2/R2，and CedV primer pair F2/R2）all demonstrated optimal amplification efficiency when combined with their corresponding probes. The optimal annealing temperature was 39 ℃，and the minimum detection limit was 101-102 copies/μl. The method could effectively distinguish target viruses from other non-target viruses，and repeated experiments showed good stability（ R2> 0.90）. Additionally，detection results for Malaysian NiV strains and various clinical samples were consistent with the Taqman multiplex qRT-PCR method. Conclusion:The duplex real-time fluorescent RT-RPA/RAA detection method successfully established in this study can rapidly and accurately identify and differentiate four important henipavirus-like viruses：NiV，LayV，MoJV，and CedV. It features simple operation，rapid reaction，high specificity，and good stability，providing an effective molecular detection tool for rapid field diagnosis，surveillance，and control of these zoonotic viruses.

Objective:To investigate the current situation of depressive symptoms, effort-reward imbalance (ERI), and sleep quality among train drivers, explore the interaction mechanism between various factors and depressive symptoms, and provide a certain theoretical basis for reducing the level of depressive symptoms among train drivers.Methods:From January to December 2022, train drivers were selected as the research subjects from the locomotive depot of a certain railway bureau through cluster sampling, with a total of 1392 people. A questionnaire survey was conducted to assess the basic situation, ERI, sleep quality and depressive symptoms of train drivers. Multiple stepwise regression was used to analyze the effects of each dimension of ERI and sleep quality on depressive symptoms, and binary logistic regression was used to analyze the effects of ERI and sleep quality on depressive symptoms.Results:Among 1392 train drivers, 897 (64.4%) were classified as having depressive symptoms. The results of multiple stepwise regression analysis showed that the dimensions of external effort, reward and overcommitment of ERI explained 10.3% of the variation in depressive symptoms ( P<0.01). Sleep quality explained 9.9% of the variation in depressive symptoms ( P< 0.01). The results of binary logistic regression analysis showed that after adjusting for confounding variables such as age, length of service, and educational level, high external effort ( OR=2.22, 95% CI: 1.76-2.79) and high overcommitment ( OR=1.90, 95% CI: 1.50-2.39) and poor sleep quality ( OR=5.82, 95% CI: 4.52-7.49) increased the risk of depressive symptoms for train drivers ( P<0.01), while reward was a protective factor for depressive symptoms ( OR=0.44, 95% CI: 0.35-0.55, P<0.01). In the ERI model, high effort and low reward was the greatest risk factor for depressive symptoms ( OR=4.77, 95% CI: 3.41-6.69, P<0.01). In the interaction between ERI and sleep quality, high ERI and poor sleep quality had the greatest negative impact on depressive symptoms ( OR=15.90, 95% CI: 7.27-34.76, P<0.01) . Conclusion:The influence of ERI on depressive symptoms of train drivers has both direct and indirect effects, and sleep quality plays a partial mediating role in the influence of ERI on depressive symptoms.

Objective The aim of this study is to evaluate the effect of the payment reform of basic medical insurance on cost,medical behavior and patients′ burden.So as to provide a reference for improving the payment reform in Changsha.Methods Interrupted time-series method was used to analyze the changes of the same-day readmission rate,average hospitalization cost per time and the out-of-pocket proportion before and after the payment reform.Stakeholder interviews were used to investigate suggestions and possible reasons for the change.Results The average hospitalization cost per time and the out-of-pocket proportion of insured patients decreased significantly in early stage of the reform,and then showed an increasing trend.The growth rate of the total number of inpatients and the decrease of same-day readmission rate declined.The results of interrupted time-series analysis showed that the growth rate of total inpatients decreased from 600 per month to 20 per month after the payment reform.The same-day readmission rate increased by 0.237%in the short term after the reform,but showed a downward trend in the long term,with the rate decreasing from 0.014%per month before the reform to 0.003%per month.In the short term after the reform,the average hospitalization cost per time fell by 786.360,and the proportion of out-of-pocket decreased by 2.089%.Conclusion The effects of controlling cost and alleviating patients′ burden were obvious in the initial reform of the basic medical insurance for urban employees in Changsha,but the long-term supervision needs to be strengthened,especially for decomposition of hospitalization and patients′burden relief.

Objective:To explore the feasibility of bibliometric analysis of research papers on human metapneumovirus based on Web of Science database.Methods:The human metapneumovirus (HMPV) causes a serious disease burden worldwide. This article used bibliometric analysis method to search for papers using the keyword " metapneumovirus" , and searched for HMPV papers published from 2001 to 2023 in the Web of Science database. Statistical analysis of the distribution of papers on HMPV by year, country, journal, research institution, author, etc., in order to understand the current research status and development trends of HMPV in the international community.Results:A total of 3 282 papers were retrieved, of which 97% were in English. HMPV was first reported in 2001, and since then, research papers have been increasing year by year. The United States has the highest number of published papers, with China, the United Kingdom, France, and the Netherlands ranked 2nd, 3rd, 4th, and 5th respectively. The field of virology-general had the highest number of papers. In terms of research institution distribution, Vanderbilt University in the United States has published 135 papers, ranked the first. The journal which had the highest number of published papers was JOURNAL OF MEDICAL VIROLOGY, with a total of 143 papers. The author Williams JV of Vanderbilt University in the United States has published 92 papers, indicating its high international status in the field of HMPV research.Conclusions:Among the retrieved HMPV related papers, research institutions and universities in European and American countries have published more papers.

Positive pressure bio-protective equipment is a key protective equipment for high-level biosafety laboratories, which provides comprehensive protection for professionals working in pathogenic microorganisms or other biological contamination environments. This paper summarizes the development status of positive pressure bio-protective equipment at home and abroad, analyzes the existing problems of the current positive pressure bio-protective equipment, and puts forward suggestions, to provide reference for the development and application of positive pressure bio-protective equipment in our country.