Objective To explore the value of analysis on the incidence of healthcare-associated infection(HAI)based on disease diagnosis-related grouping(DRG),case mix index(CMI),and relative weight(RW).Methods All discharged cases,DRG and HAI status in a tertiary first-class general hospital from January 1 to December 31,2023 were analyzed retrospectively.Incidences of HAI in different departments were adjusted and compared by CMI.Incidences of HAI in different DRG groups were adjusted by RW.Results Among the 47 695 cases included in the analysis,757 were HAI cases,including 225 DRG groups.The department of critical care medicine had the highest incidence of HAI(11.98％).After CMI adjustment,departments with higher incidence of HAI were main-ly the department of respiratory and critical care medicine(3.96％),department of critical care medicine(3.04％),and department of neurology(2.85％),et al.DRG groups with the top five high incidence of HAI were AH11(tracheotomy and with ventilator support ≥96 hours or extracorporeal membrane oxygenation[ECMO],accompa-nied by major complications and comorbidity[MCC],50.00％),BC29(ventricular shunt and revision surgery,31.43％),BB21(craniotomy other than trauma,accompanied by MCC,27.56％),BB11(craniotomy of brain trauma,accompanied by MCC,26.32％),and GB1A(major surgery of esophagus,stomach,and duodenum,accompanied by major or moderate complications and comorbidity,16.00％).After RW adjustment,the DRG groups with the top five high incidence of HAI were ES21(respiratory system infection/inflammation,accompanied by MCC,5.89％),BR21(cerebral ischemic disease,accompanied by MCC,5.17％),FR11(heart failure,shock,accompanied by MCC,4.80％),BC29(4.57％)and AH11(3.57％).Conclusion Analyzing the incidence of HAI based on CMI and RW can help to identify key departments and disease groups for infection prevention and control,and provide reference for precise prevention and control of HAI in the new era.

Objective:To investigate the current situation of knowledge, attitude and practice of medical personnel in areas with high incidence of fever with thrombocytopenia syndrome (SFTS) in Anhui Province, in order to provide a scientific basis for conducting systematic training for medical personnel.Methods:From July to August 2024, a multi-stage random sampling method was used to select medical personnel from village, township, county, and city level medical institutions in high incidence areas of SFTS in Anhui Province (Hefei City, Liu'an City, Chuzhou City, Xuancheng City) for an online questionnaire survey on their knowledge, attitude, and practice status. The survey included demographic data, knowledge, attitude, and practice related to SFTS, and a binary logistic regression model was used to analyze the influencing factors of SFTS knowledge qualification rate.Results:A total of 2 718 valid questionnaires were collected, with an effective response rate of 99.60% (2 718/2 729). Among them, 1 384 were males, accounting for 50.92%. The majority were medical personnel aged 41 to 50 years old, with undergraduate degrees, junior professional titles, working in township health centers or community health service centers, as clinical physicians, and with a working experience of no more than 10 years. They accounted for 31.97% (869/2 718), 50.48% (1 372/2 718), 35.54% (966/2 718), 38.52% (1 047/2 718), 62.33% (1 694/2 718), and 30.61% (832/2 718), respectively. The overall correct rates of medical personnel's relevant knowledge, attitude and practice were 77.52% (31 605/40 770), 94.53% (12 847/13 590) and 89.73% (12 194/13 590), respectively. There were statistically significant differences in the knowledge qualification of medical personnel of different genders, ages, education levels, professional titles, hospital levels, job positions, and years of work experience ( P < 0.05). The results of binary logistic regression analysis showed that professional title, hospital level, work position, and work experience were the influencing factors of knowledge qualification rate ( P < 0.05). Conclusions:Medical personnel have a relatively positive attitude and high level of practice towards SFTS, but their knowledge level still needs to be improved. It is recommended to provide targeted knowledge training for medical personnel in different positions to promote early detection, diagnosis, and treatment of SFTS.

Objective:To establish a detection method for fatty acid composition and methoxylaniline value in pharmaceutical excipient castor oil.Methods:The detection of fatty acid composition involves pre-test of the sam-ple using the methanol sodium methylation method,followed by direct injection analysis using gas chromatography,and finally calculating the content of each fatty acid composition using the area normalization method with correction factors.The detection of methoxylaniline value is achieved by dissolving and diluting the sample with isooctane:isopropanol(8∶2,volume ratio),reacting with 4-methoxylaniline,measuring the absorbance at a wavelength of 350 nm,and calculating the methoxylaniline value.Results:Under the composition of fatty acids,the 8 kinds of fatty acids have good separation degree.The methyl ricinoleate and methyl stearate have good linear relationship in the range of 0.1-5.0 mg·mL-1.The repeatabilityand intermediate precision(RSD)ofthe determination results of each fatty acid in the sample are all less than 5%.It is also found that only α-type of linolenic acid is present in castor oil,without γ-type.In the determination of methoxyaniline value,the blank solvent does not interfere with the determination of the sample,and the repeatability RSD is 3.6%.Conclusion:The detection method for fatty acid composition and meth-oxylaniline value established in this article is accurate and reliable,and can be used for the detection of fatty acid composition and methoxylaniline value in pharmaceutical excipient castor oil.

Objective To investigate the relationship between lumbosacral Modic changes(MCs)and their types and osteoporosis in patients with low back pain.Methods A total of 204 female patients with low back pain who were treated in Xuzhou City Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from January 2021 to September 2024 were selected as study objects.According to magnetic resonance imaging results,the patients were divided into MCs group(139 cases)and non-MCs group(65 cases).MCs group was divided into type Ⅰ group(33 cases),type Ⅱgroup(90 cases)and type Ⅲ group(16 cases)according to MCs type.The age,hip bone mineral density(BMD)and T value of all groups were compared.Results There was no significant difference in age,hip BMD and T value between MCs group and non-MCs group(P＞0.05).Hip BMD and T values of four groups were type Ⅲ group＞non-MCs group＞type Ⅱ group＞typeⅠ group.Most of patients in type Ⅲ group had normal bone mass,and most of patients in other three groups had decreased bone mass or osteoporosis.There was no significant difference in hip BMD and T value between type Ⅱ group and non-MCs group(P＞0.05).The hip BMD and corresponding T values of patients in group Ⅲ significantly higher than the other three groups(P＜0.05).The hip BMD and corresponding T values of type Ⅰ patients were significantly lower than those of the other three groups(P＜0.05).Conclusion Patients with low back pain have different tendency of MCs with different bone mass.High bone mass(normal bone mass)is more likely to develop type Ⅲ MCs,and low bone mass or osteoporosis is more likely to develop type Ⅰ MCs.Anti-osteoporosis therapy for patients with type Ⅰ MCs should be emphasized.

Objective:To investigate the current situation of knowledge, attitude and practice of medical personnel in areas with high incidence of fever with thrombocytopenia syndrome (SFTS) in Anhui Province, in order to provide a scientific basis for conducting systematic training for medical personnel.Methods:From July to August 2024, a multi-stage random sampling method was used to select medical personnel from village, township, county, and city level medical institutions in high incidence areas of SFTS in Anhui Province (Hefei City, Liu'an City, Chuzhou City, Xuancheng City) for an online questionnaire survey on their knowledge, attitude, and practice status. The survey included demographic data, knowledge, attitude, and practice related to SFTS, and a binary logistic regression model was used to analyze the influencing factors of SFTS knowledge qualification rate.Results:A total of 2 718 valid questionnaires were collected, with an effective response rate of 99.60% (2 718/2 729). Among them, 1 384 were males, accounting for 50.92%. The majority were medical personnel aged 41 to 50 years old, with undergraduate degrees, junior professional titles, working in township health centers or community health service centers, as clinical physicians, and with a working experience of no more than 10 years. They accounted for 31.97% (869/2 718), 50.48% (1 372/2 718), 35.54% (966/2 718), 38.52% (1 047/2 718), 62.33% (1 694/2 718), and 30.61% (832/2 718), respectively. The overall correct rates of medical personnel's relevant knowledge, attitude and practice were 77.52% (31 605/40 770), 94.53% (12 847/13 590) and 89.73% (12 194/13 590), respectively. There were statistically significant differences in the knowledge qualification of medical personnel of different genders, ages, education levels, professional titles, hospital levels, job positions, and years of work experience ( P < 0.05). The results of binary logistic regression analysis showed that professional title, hospital level, work position, and work experience were the influencing factors of knowledge qualification rate ( P < 0.05). Conclusions:Medical personnel have a relatively positive attitude and high level of practice towards SFTS, but their knowledge level still needs to be improved. It is recommended to provide targeted knowledge training for medical personnel in different positions to promote early detection, diagnosis, and treatment of SFTS.

Objective To explore the value of analysis on the incidence of healthcare-associated infection(HAI)based on disease diagnosis-related grouping(DRG),case mix index(CMI),and relative weight(RW).Methods All discharged cases,DRG and HAI status in a tertiary first-class general hospital from January 1 to December 31,2023 were analyzed retrospectively.Incidences of HAI in different departments were adjusted and compared by CMI.Incidences of HAI in different DRG groups were adjusted by RW.Results Among the 47 695 cases included in the analysis,757 were HAI cases,including 225 DRG groups.The department of critical care medicine had the highest incidence of HAI(11.98％).After CMI adjustment,departments with higher incidence of HAI were main-ly the department of respiratory and critical care medicine(3.96％),department of critical care medicine(3.04％),and department of neurology(2.85％),et al.DRG groups with the top five high incidence of HAI were AH11(tracheotomy and with ventilator support ≥96 hours or extracorporeal membrane oxygenation[ECMO],accompa-nied by major complications and comorbidity[MCC],50.00％),BC29(ventricular shunt and revision surgery,31.43％),BB21(craniotomy other than trauma,accompanied by MCC,27.56％),BB11(craniotomy of brain trauma,accompanied by MCC,26.32％),and GB1A(major surgery of esophagus,stomach,and duodenum,accompanied by major or moderate complications and comorbidity,16.00％).After RW adjustment,the DRG groups with the top five high incidence of HAI were ES21(respiratory system infection/inflammation,accompanied by MCC,5.89％),BR21(cerebral ischemic disease,accompanied by MCC,5.17％),FR11(heart failure,shock,accompanied by MCC,4.80％),BC29(4.57％)and AH11(3.57％).Conclusion Analyzing the incidence of HAI based on CMI and RW can help to identify key departments and disease groups for infection prevention and control,and provide reference for precise prevention and control of HAI in the new era.

Objective:To establish a detection method for fatty acid composition and methoxylaniline value in pharmaceutical excipient castor oil.Methods:The detection of fatty acid composition involves pre-test of the sam-ple using the methanol sodium methylation method,followed by direct injection analysis using gas chromatography,and finally calculating the content of each fatty acid composition using the area normalization method with correction factors.The detection of methoxylaniline value is achieved by dissolving and diluting the sample with isooctane:isopropanol(8∶2,volume ratio),reacting with 4-methoxylaniline,measuring the absorbance at a wavelength of 350 nm,and calculating the methoxylaniline value.Results:Under the composition of fatty acids,the 8 kinds of fatty acids have good separation degree.The methyl ricinoleate and methyl stearate have good linear relationship in the range of 0.1-5.0 mg·mL-1.The repeatabilityand intermediate precision(RSD)ofthe determination results of each fatty acid in the sample are all less than 5%.It is also found that only α-type of linolenic acid is present in castor oil,without γ-type.In the determination of methoxyaniline value,the blank solvent does not interfere with the determination of the sample,and the repeatability RSD is 3.6%.Conclusion:The detection method for fatty acid composition and meth-oxylaniline value established in this article is accurate and reliable,and can be used for the detection of fatty acid composition and methoxylaniline value in pharmaceutical excipient castor oil.

BackgroundSevere mental disorders are characterized by high recurrence rate， high disability rate， high rates of harmful incidents， and low treatment-seeking rate， with affected patients demonstrating increased frequencies of dangerous behaviors. Ningxia Hui Autonomous Region has implemented community management for patients with severe mental disorders across the region since 2004， while the current status and regional characteristics of the managed patients remain unclear. ObjectiveTo analyze the current status of management and treatment of patients with severe mental disorders in Ningxia Hui Autonomous Region， and to explore their regional distribution characteristics， so as to provide references for optimizing regional prevention and control strategies. MethodsPatients with severe mental disorders diagnosed and registered in the Severe Mental Disorder Management Information Platform of Ningxia Hui Autonomous Region from August 1， 2011 to December 31， 2021 were selected. Patients' basic information， management indicators， and treatment metrics were extracted from the platform， followed by descriptive statistical analysis of the corresponding data. ResultsAs of December 31， 2021， the permanent resident population of Ningxia Hui Autonomous Region was 6 946 540， with 29 787 registered patients with severe mental disorders. The majority of the patients were female （50.25%）， aged 18-59 years （79.01%）， with educational level of junior high school or below （84.63%）， married （52.87%）， farmers （56.01%）， and diagnosed with schizophrenia （55.91%）， while ethnic minority patients accounted for a relatively high proportion （31.35%）. In 2021， the reported prevalence rate of severe mental disorders in Ningxia Hui Autonomous Region was 0.43%， with standardized management and regular medication adherence rates at 90.39% and 66.34%， respectively. The standardized management rate in 8 counties/districts （36.36%） was lower than the average level of Ningxia Hui Autonomous Region， while 10 counties/districts （45.45%） showed below-average medication adherence rates， of which 6 counties/districts（60.00%） were located in the south-central region. ConclusionPatients with severe mental disorders in Ningxia Hui Autonomous Region are predominantly young and middle-aged adults with low level of education， and those in the central-southern region demonstrate lower medication adherence. ［Funded by Key Research and Development Program Project of Ningxia Hui Autonomous Region （number， 2023BEG02029）］

Objective:To elucidate the genomic characteristics of the immunoglobulin (IG) heavy-chain variable region and light-chain variable region, the expression of subclones, and the prognostic significance in patients with CLL.Methods:Blood and/or bone marrow specimens were gathered from a cohort of 36 patients with CLL diagnosed at Jiangsu Province Hospital from December 2018 to May 2023, including 12 cases of B cell receptor (BCR) stereotyped patients. IG heavy-chain (IGH) and light-chain (IG Kappa [IGK] and IG lambda [IGL]) gene rearrangements were performed using next-generation sequencing (NGS) technology to analyze the characteristics and prognostic value in CLL.Results:NGS detection of IG variable region (IGHV) demonstrated a significant correlation and superior consistency with Sanger sequencing ( r=0.957, P < 0.001). Among the 36 patients, the IGH variant (IGHV) was observed in 9 (25.0%) but not in 27 (75.0%) participants. The incidence of the MYD88 mutation was higher among patients with mutated IGHV [1/27 (3.7%) vs 4/9 (44.4%), P=0.00]. A high incidence of trisomy 12 was observed in the IGHV #8/#8B subset [4/11 (36.4%) vs 1/25 (4.0%), P=0.023], which were more likely to develop Richter transformation [8/11 (72.7%) vs 4/25 (16.0%), P=0.002]. In the patient cohort, 36 individuals (36/36, 100.0%) used the IGK variable, whereas 15 individuals (15/36, 41.7%) employed the IGL variable (IGLV). IGLV3 - 21 reported the highest utilization rate in IGLV (5/15, 33.3%). Remarkably, patients with CLL with IGLV3-21 fragments were exclusively observed in the Binet C stage and Rai Phase Ⅲ-Ⅳ, with an incidence of del (13) (q14) at 60.0% (3/5). The median time to first treatment (TTFT) of patients with or without IGLV3 - 21 fragments was 5.2 (1.1 - 41.5) and 9.9 (0.1 - 94.4) months, respectively. Using the total reads threshold of 2.5%, 4 (4/36, 11.1%) samples were detected to have two IGHV productive clones. The median TTFT and overall survival (OS) time were 2.8 (0.9-72.7) and 12.8 months in patients with one mutated clone and 57.5 (32.0-120.7) and 51.8 months in those with two mutated clones, respectively. The median TTFT and OS time were 10.9 (0.3-94.4) and 6.3 (0.1 - 12.5) months in patients with one unmutated clone and 49.9 (22.2 - 211.1) and 30.0 (9.6 - 50.3) months in those with multiple unmutated clones, respectively ( P>0.05) . Conclusions:Detection of IG gene rearrangements using NGS technology not only facilitates the analysis of the IGHV mutation status, dominant clones, and prognostic value but also contributes to the exploration of IGK/IGL gene rearrangement fragments and the utilization of subclones. Further, it provides information about the poor prognosis of IGLV3 - 21 CLL. The shortened survival of the two unmutated clone groups in the IGHV unmutated group may indicate a poor prognosis.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.