Facing escalating public health security challenges,infectious disease hospitals have assumed a pivotal role in fortifying the public health service infrastructure.This paper adopts case-based analytical approach,based on Nantong Third Peo-ple's Hospital(Nantong Infectious Disease Center),to explore the"One Hospital,Two Campuses"development model in infec-tious disease hospitals.It analyzes practical strategies for resource integration,functional optimization,and emergency response mechanisms.In addition,this paper highlights the model's role in enhancing public health service capacity,addressing sudden infectious disease outbreaks,and fostering regional healthcare collaboration.The study aims to offer theoretical insights and prac-tical guidance for further improvements in the public health service system.

Objective:To explore the safety and efficacy of intraosseous regional administration (IORA) of vancomycin for preventing infection in primary total knee arthroplasty (TKA).Methods:A total of 124 patients with knee osteoarthritis undergoing TKA between February 2024 and May 2024 at nine hospitals were enrolled. Preoperative infection prophylaxis involved either IORA (0.5 g vancomycin administered via intraosseous regional infusion before incision) or intravenous infusion (1 g vancomycin via peripheral vein). The IORA group included 15 males and 47 females with a median age of 66.5 years (range, 60.0-70.0 years), while the intravenous group included 14 males and 48 females with a median age of 66.0 years (range, 61.8-70.3 years) years. Intraoperative samples were collected including fat and synovium tissues after incision, before prosthesis placement, and after tourniquet release; distal femoral cancellous bone during femoral osteotomy; proximal tibial cancellous bone during tibial osteotomy; proximal intercondylar cancellous bone before prosthesis placement; and peripheral blood from non-infused arms at surgery initiation and after tourniquet release. Vancomycin concentrations were measured using liquid chromatography-tandem mass spectrometry. Vital sign changes were recorded from admission to 5~10 minutes post-IORA (IORA group) or post-incision (intravenous group). Follow-ups were conducted on postoperative day 1 and 3, and at 1 and 3 months, to document complications including IORA-related adverse events, periprosthetic joint infections, surgical site infections, red man syndrome, acute kidney injury, deep vein thrombosis and so on.Results:Vancomycin concentrations in bone, fat, and synovial tissue samples were significantly higher in the IORA group than in the intravenous group ( P<0.05), while vancomycin concentrations in blood samples were significantly lower in the IORA group than in the intravenous group ( P<0.05). Only 7.3%(41/558) of tissue samples in the IORA group had vancomycin concentrations below 2.0 μg/g (the minimum inhibitory concentration of vancomycin against coagulase-negative staphylococcus), compared to 59.3%(331/558) in the intravenous group (χ 2=11.285, P<0.001). In the intravenous group, 16.9%(21/124) of blood samples had vancomycin concentrations exceeding 15.0 mg/L (the threshold associated with a significantly increased risk of nephrotoxicity), while all concentrations in the IORA group were below this threshold, the difference was statistically significant (χ 2=22.943, P<0.001). There were no statistically significant difference ( P>0.05) in vital signs changes before and after vancomycin administration between the two groups. Two patients in the intravenous group experienced incision exudate, while no other related complications occurred in either group. Conclusions:Compared to the traditional intravenous infusion of 1 g vancomycin, intraosseous injection of a low dose (0.5 g) of vancomycin achieves higher local tissue concentrations in the knee joint with a lower incidence of adverse reactions and is safe for infection prophylaxis. Despite guidelines not recommending the routine use of vancomycin for preventing infection after primary TKA, intraosseous injection of 0.5 g vancomycin may be considered intraoperatively for primary TKA in the following scenarios: patients in medical institutions with a high prevalence of methicillin-resistant staphylococcus aureus (MRSA) infections, patients with potential preoperative MRSA colonization, or patients with cephalosporin allergy.

Objective:To explore the safety and efficacy of intraosseous regional administration (IORA) of vancomycin for preventing infection in primary total knee arthroplasty (TKA).Methods:A total of 124 patients with knee osteoarthritis undergoing TKA between February 2024 and May 2024 at nine hospitals were enrolled. Preoperative infection prophylaxis involved either IORA (0.5 g vancomycin administered via intraosseous regional infusion before incision) or intravenous infusion (1 g vancomycin via peripheral vein). The IORA group included 15 males and 47 females with a median age of 66.5 years (range, 60.0-70.0 years), while the intravenous group included 14 males and 48 females with a median age of 66.0 years (range, 61.8-70.3 years) years. Intraoperative samples were collected including fat and synovium tissues after incision, before prosthesis placement, and after tourniquet release; distal femoral cancellous bone during femoral osteotomy; proximal tibial cancellous bone during tibial osteotomy; proximal intercondylar cancellous bone before prosthesis placement; and peripheral blood from non-infused arms at surgery initiation and after tourniquet release. Vancomycin concentrations were measured using liquid chromatography-tandem mass spectrometry. Vital sign changes were recorded from admission to 5~10 minutes post-IORA (IORA group) or post-incision (intravenous group). Follow-ups were conducted on postoperative day 1 and 3, and at 1 and 3 months, to document complications including IORA-related adverse events, periprosthetic joint infections, surgical site infections, red man syndrome, acute kidney injury, deep vein thrombosis and so on.Results:Vancomycin concentrations in bone, fat, and synovial tissue samples were significantly higher in the IORA group than in the intravenous group ( P<0.05), while vancomycin concentrations in blood samples were significantly lower in the IORA group than in the intravenous group ( P<0.05). Only 7.3%(41/558) of tissue samples in the IORA group had vancomycin concentrations below 2.0 μg/g (the minimum inhibitory concentration of vancomycin against coagulase-negative staphylococcus), compared to 59.3%(331/558) in the intravenous group (χ 2=11.285, P<0.001). In the intravenous group, 16.9%(21/124) of blood samples had vancomycin concentrations exceeding 15.0 mg/L (the threshold associated with a significantly increased risk of nephrotoxicity), while all concentrations in the IORA group were below this threshold, the difference was statistically significant (χ 2=22.943, P<0.001). There were no statistically significant difference ( P>0.05) in vital signs changes before and after vancomycin administration between the two groups. Two patients in the intravenous group experienced incision exudate, while no other related complications occurred in either group. Conclusions:Compared to the traditional intravenous infusion of 1 g vancomycin, intraosseous injection of a low dose (0.5 g) of vancomycin achieves higher local tissue concentrations in the knee joint with a lower incidence of adverse reactions and is safe for infection prophylaxis. Despite guidelines not recommending the routine use of vancomycin for preventing infection after primary TKA, intraosseous injection of 0.5 g vancomycin may be considered intraoperatively for primary TKA in the following scenarios: patients in medical institutions with a high prevalence of methicillin-resistant staphylococcus aureus (MRSA) infections, patients with potential preoperative MRSA colonization, or patients with cephalosporin allergy.

Facing escalating public health security challenges,infectious disease hospitals have assumed a pivotal role in fortifying the public health service infrastructure.This paper adopts case-based analytical approach,based on Nantong Third Peo-ple's Hospital(Nantong Infectious Disease Center),to explore the"One Hospital,Two Campuses"development model in infec-tious disease hospitals.It analyzes practical strategies for resource integration,functional optimization,and emergency response mechanisms.In addition,this paper highlights the model's role in enhancing public health service capacity,addressing sudden infectious disease outbreaks,and fostering regional healthcare collaboration.The study aims to offer theoretical insights and prac-tical guidance for further improvements in the public health service system.

AIM: To compare the efficacy of intravitreal injection of ranibizumab(IVR)and intravitreal injection of conbercept(IVC)in children with retinopathy of prematurity(ROP).METHODS: Retrospective study. A total of 1 100 eyes with ROP treated with intravitreal anti-VEGF at our hospital from January 2015 to June 2023 were included. According to the different therapeutic drugs, the children were divided into two groups: IVR group and IVC group. According to the degree of ROP, the patients were divided into three groups: aggressive ROP(A-ROP), Zone Ⅰ type 1 ROP and Zone Ⅱ type 1 ROP. The reactivation and retreatment between the two groups were compared after propensity score matching(PSM)analysis, and they were followed-up for at least 3 mo after surgery.RESULTS: In Zone Ⅱ type 1 ROP, there was a statistically significant difference in the rates of reactivation and retreatment between the IVR and IVC groups(P<0.05); however, in A-ROP and Zone I type 1 ROP, there were no statistically significant differences in the rates of reactivation and retreatment between the two groups(P>0.05). The risk of reactivation and retreatment of Zone I type 1 ROP was higher than the Zone II type 1 ROP. Furthermore, the use of drugs and corrected gestational age of first treatment were influencing factors of lesion recurrence and retreatment.CONCLUSION: There is a significant difference in the initial cure effect between the two drugs in Zone II type 1 ROP, with the reactivation and retreatment rates of the IVC group being much lower than those of the IVR group.

Objective:To analyze the time of recovery to the respiratory baseline after treatment of retinopathy of prematurity (ROP) and the possible influencing factors.Methods:The preterm infants with ROP who received ophthalmic treatment from January 2016 to December 2020 in the Department of Neonatology, Guangdong Women and Children′s Hospital were enrolled retrospectively.The baby who received vitreous injection were included in the injection group, and who received laser photocoagulation were included in the photocoagulation group.The patients were divided into two groups according to whether they returned to the respiratory baseline within 48 hours after ROP surgery.Relevant data were collected, including respiratory baseline, the respiratory status 24 hours, 48 hours, 72 hours, 96 hours, 5 days and 7 days after treatment, gestational age, birth weight, gender, corrected gestational age at surgery, weight at surgery, laser points, and treatment location.Wilcoxon signed-rank test was used for continuous variables. Data were expressed as the number and percentage of patients for categorical variables, using Chi-square test or Fisher′ s exact test. Binary Logistic regression analysis was used to analyze the influencing factors.The time taken by preterm infants to return to the preoperative respiratory baseline after treatment and its influencing factors were analyzed. Results:A total of 386 ROP infants were included in this study.There were 157 infants who did not return to the respiratory baseline within 48 hours after treatment.No significant difference in the source, gender, gestational age, birth weight, corrected gestational age at surgery, weight at surgery, and respiratory pressure support required before surgery were found between the group who returned to the respiratory baseline within 48 hours and the group who did not (all P>0.05). However, there were significant differences in treatment methods and location between two groups (all P<0.01). The ratio of returning to the respiratory baseline in the group receiving intravitreal injection was significantly different from that in the group treated with laser therapy at 24 h, 48 h, 72 h, and 96 h after treatment (77% vs.14%, 82% vs.33%, 86% vs.58%, 89% vs.76%; all P<0.01). There was no difference in that ratio between two groups at 5 d and 7 d after treatment (91% vs.86%, 95% vs.92%; P>0.05). Of the 157 infants who did not return to the respiratory baseline within 48 hours after treatment, 108 cases (68.8%) required additional supplemental oxygen, whereas 153 cases (98.5%) required more intensive respiratory support ( P<0.001). According to the multivariate Logistic regression analysis results, the preterm infants who received laser therapy were less likely to return to the respiratory baseline within 48 hours than those who received intravitreal injection ( OR=0.099, 95% CI: 0.060-0.164). A small corrected gestational age at surgery was an independent risk factor for infants not returning to the respiratory baseline within 48 hours ( OR=1.147, 95% CI: 1.009-1.302). Conclusions:Infants with ROP who receive intravitreal injection can return to the respiratory baseline more quickly than those who underwent laser photo-coagulation under. The difference persisted up to 4 days. The smaller the corrected gestational age at treatment, the less likely return to the respiratory baseline within 48 hours in photocoagulation group..

Objective:To explore the incidence, diagnosis and treatment of retinopathy of prematurity(ROP) in preterm infants born in the Guangdong Women and Children′s Hospital and transported from other hospital.Method:s Clinical data of 755 premature infants with ROP at Neonatal Intensive Care Unit, Guangdong Women and Children′s Hospital from January 2013 to December 2015 were retrospectively analyzed.There were 239 cases born in the hospital and 516 cases transported from other hospitals.Their gestational age, birth weight, gender, severity of ROP lesion and clinical data were collected and compared.Result:s The birth weight in the group of transported from other hospital was lower than that in the group of born in the hospital[(1 290.64±392.87) g vs.(1 586.21±512.74) g], and the difference was statistically significant( P<0.001). The ROP diagnosis of gestational age in the group of transported from other hospital was higher than that in the group of born in the hospital[(35.53±2.81)weeks vs.(34.51±2.17)weeks], and the difference was statistically significant( P<0.001). On the proportion of severe condition [such as lesion area Ⅰ, aggressive posterior retinopathy of prematurity(AP-ROP) and plus combined lesions], in the group of transported from other hospital was higher than that in the group of born in the hospital, and the differences was statistically significant( P<0.001). In the comparison of the proportion of laser photocoagulation, vitreous injection, combination of the two operations and supplementary laser therapy, in the group of transported from other hospital were higher than those in the group of born in the hospital[60.1%(310/516 cases) vs.20.9%(50/239 cases); 10.9%(56/516 cases) vs.2.5%(6/239 cases); 8.1%(42/516 cases) vs.1.7%(4/239 cases); 4.5%(23/516 cases) vs.1.3%(3/239 cases)], and the differences were statistically significant(all P<0.001). Conclusions:Premature infants with ROP transported from other hospitals have lower birth weight, severe ROP lesions and high surgical intervention rate.Improving ROP screening level in primary hospitals, timely diagnosis and efficient transportation can help to effectively prevent the deterioration of ROP in premature infants and improve their quality of life.

s] Objective To evaluate the effect of comprehensive schistosomiasis control measures with focus on total removal of cattle and sheep in Junshan District,Yueyang City. Methods The retrospective review and field survey were implemented in the pilot villages in Junshan District. The data of Schistosoma japonicum infection status of human,cattle,sheep and Oncome-lania hupensis snails,and density of snails were gathered and modeled in the period of 2006 to 2016. Results The prevalence of schistosome infection in residents in the pilot villages decreased from 3.44％ in 2006 to 0.59％ in 2012(F = 14.501,P =0.013). After removal of all the cattle and sheep in 2013,the prevalence of schistosome infection in the residents decreased to zero in 2016(F=14.148,P=0.033). The density of living snails decreased from 0.8833/0.1 m2 in 2006 to 0.3088/0.1 m2 in 2012(F=76.250,P=0.005). Conclusion The comprehensive schistosomiasis control strategy with focus on cattle and sheep removal is remarkably effective.

Objective To study the changes of serum myeloperoxidase(MPO)in patients with acute ischemic stroke ,and to probe into the relationship of serum MPO with types of carotid atherosclerotic plaques ,the degree of neural function defect and the activi‐ties of daily living (Barthel Index) .Methods Totally 78 cases of patients with acute ischemic stroke was selected as observation ob‐jects .The patients with acute ischemic stroke were divided into good ,medium and poor three groups according to Barthel index . Based on the scoring of neurologic impairment degree from standards of CSS :mild impairment group(0 to 15 points) ,moderate im‐pairment group(16 to 30 points) ,and severe impairment group(31 to 45 points) .Based on the type of atherosclerotic plaques all pa‐tients were divided into soft plaque group ,mixed plaque and hard plaque group .The 1evels of serum MPO was compared between different group .Results The heavier nerve function defect degree ,the levels of serum MPO in patients with ischemic stroke were higher ,and it had significant difference between groups (P<0 .05) .The Barthel index was the better ,the levels of serum MPO was lower .The levels of serum MPO was different among the soft plaque group ,mixed plaque and hard plaque group ,and its were sig‐nificantly different between the three groups ,and the type of atherosclerotic plaque was related to the neural function defect and Barthel index level .Conclusion Ischemic stroke is associated with serum MPO levels ,neurological deficits ,Barthel index and stabil‐ity of atherosclerotic plaque ,and the levels of serum M PO is helpful for judging state of the disease and guiding in clinical diagnosis and treatment .

AIM:To investigate the pathologic role of aldosterone and protective effect of aldosterone receptor antagonist on peritoneal fibrosis in peritoneal dialysis rats .METHODS:A peritoneal fibrosis rat model was established by intraperitoneal injection of lipopolysaccharide ( at 1 d, 3 d, 5 d and 7 d, 0.6 mg/kg) and dialysate ( daily intraperitoneal injection of 4.25%dialysate, 100 mL/kg).At the same time, spironolactone (an aldosterone receptor antagonist , 100 mg? kg -1? d-1 ) was given to the model rats .After 4 weeks, the expression of aldosterone synthase CYP 11B2, 11β-hydrox-ysteroid dehydrogenase type 2 (11β-HSD2), mineralocorticoid receptor (MCR), and inflammatory factors were detected by immunohistochemistry , real-time PCR and Western blotting .RESULTS:The rat model of peritoneal fibrosis was suc-cessfully established .At the same time, the injury of mesothelial cells , deposition of collagen fibers and thickness of perito-neal were increased .Moreover , the infiltration of macrophages in the peritoneum/dialysate was increased .The level of al-dosterone and the expression of MCR , 11β-HSD2 and CYP11B2 in fibrotic peritoneum were obviously up-regulated as com-pared with normal rats .The expression of NF-κB/MCP-1 was also increased .However , treatment with spironolactone alle-viated peritoneal fibrosis and reduced the expression of NF-κB/MCP-1.CONCLUSION:Local aldosterone is involved in the process of peritoneal fibrosis via NF-κB/MCP-1 pathway.Spironolactone alleviates peritoneal fibrosis of peritoneal dial-ysis.