Hemodialysis patients exhibit compromised immune function and require long-term repeated vascular punctures as therapeutic approach,the risk of infection increases.Hospital-associated infection in hemodialysis de-partment(center)happens from time to time,which has already become a concern for the medical community,patients and social media.This paper outlines the task origin of China's"Standard for infection prevention and control in hemodialysis department(center)"(WS/T854-2025),the compilation basis and explanations for its key content,feasibility and implementation recommendations,as well as the clarifications on common issues encoun-tered during its promotion and enforcement.

Hemodialysis patients exhibit compromised immune function and require long-term repeated vascular punctures as therapeutic approach,the risk of infection increases.Hospital-associated infection in hemodialysis de-partment(center)happens from time to time,which has already become a concern for the medical community,patients and social media.This paper outlines the task origin of China's"Standard for infection prevention and control in hemodialysis department(center)"(WS/T854-2025),the compilation basis and explanations for its key content,feasibility and implementation recommendations,as well as the clarifications on common issues encoun-tered during its promotion and enforcement.

Objective:To explore and summarize the morphological features of laryngeal tuberculosis under electronic laryngoscopy and image-enhanced endoscopy (i-scan).Methods:A retrospective analysis was conducted on the data of 31 patients diagnosed with laryngeal tuberculosis at the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2014 to June 2024, encompassing the morphological features of electronic laryngoscopy and i-scan endoscopy, histopathological features, and supplementary clinical examination results. Descriptive statistical methods were employed for the analysis.Results:Thirty-one patients were diagnosed with laryngeal tuberculosis, including 25 males and 6 females, aged from 21 to 84 years old, with an average age of 57 years old, and the disease course was from 1 to 12 months with an average of 3 months. The clinical symptoms included hoarseness in 27 cases, foreign body sensation in the pharynx in 2 cases, and sore throat in 2 cases. Twenty-six cases involved a single site, including 24 cases of the vocal cords, 1 case of the ventricular bands, and 1 case of the epiglottis; 5 cases involved multiple sites, including 2 cases of the vocal cords and the interarytenoid area, 2 cases of the aryepiglottic fold and the epiglottis, and 1 case of the aryepiglottic fold, the ventricular bands and the epiglottis. Eighteen patients showed a single morphology type under electronic laryngoscopy, including 4 cases of the edematous exudative type, 5 cases of the ulcerative type, and 9 cases of the granulation hyperplasia type. Edema, ulcer, and granulation hyperplasia can coexist and transit between each other. A total of 13 cases presented with two or more morphological types, with the edematous exudative type, the ulcerative type, and the granulation hyperplasia type occurred 7, 9, and 10 times respectively. Twenty-two patients had active or chronic pulmonary tuberculosis, while 9 patients had normal lung imaging. The laryngeal tissue biopsy pathology of 21 patients was chronic granuloma, and 10 patients were chronic granuloma with caseous necrosis; among them, 19 cases completed the Ziel-Neelsen staining (7 cases were positive for acid-fast bacilli), and 3 cases completed the polymerase chain reaction (PCR) (All were positive). Twenty cases completed the T-cell assay for tuberculosis infection (19 cases were positive), 15 cases completed the sputum smear (6 cases were positive), 18 cases were tested for antinuclear antibody (6 cases were positive), and 14 cases completed the erythrocyte sedimentation rate (4 cases were positive). Six patients underwent i-scan examination. In cases of ulcerative laryngeal tuberculosis without granulation hyperplasia in the surrounding tissues, i-scan revealed an abundance of abundant slightly thickened and tortuous oblique and dendritic blood vessels around the ulcer. If the pseudomembrane in the deep ulcer was thick, the blood vessel shadow was not visible. In shallow ulcers, there were areas of deep congestion and scattered dot-shaped blood vessel shadowst with uneven distribution; in cases of laryngeal tuberculosis with coexistence of the edematous exudative type and the granuloma type, i-scan visualized laryngeal cord edema with white exudates on the surface. Beneath the laryngeal cord exudates, there were scattered dot-shaped and irregularly distorted linear blood vessel shadows with uneven distribution, and tortuous, oblique, and dendritic blood vessels were observed around the lesion. In granuloma-type laryngeal tuberculosis, i-scan demonstrated that the area of granulation hyperplasia around the ulcer focus was significantly congested, characterized by scattered thick dot-shaped blood vessel shadows and irregularly distorted linear blood vessel shadows.Conclusions:Laryngeal tuberculosis presents as the edematous exudative type, the ulcerative type, and the granulation hyperplasia type under electronic laryngoscopy, and these types can coexist and interact. i-scan endoscopy can reveal detailed microvascular morphology and other subtle morphological characteristics. The identification and summary of these morphological characteristics are beneficial for the early detection and diagnosis of laryngeal tuberculosis.

Objective:To explore and summarize the morphological features of laryngeal tuberculosis under electronic laryngoscopy and image-enhanced endoscopy (i-scan).Methods:A retrospective analysis was conducted on the data of 31 patients diagnosed with laryngeal tuberculosis at the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2014 to June 2024, encompassing the morphological features of electronic laryngoscopy and i-scan endoscopy, histopathological features, and supplementary clinical examination results. Descriptive statistical methods were employed for the analysis.Results:Thirty-one patients were diagnosed with laryngeal tuberculosis, including 25 males and 6 females, aged from 21 to 84 years old, with an average age of 57 years old, and the disease course was from 1 to 12 months with an average of 3 months. The clinical symptoms included hoarseness in 27 cases, foreign body sensation in the pharynx in 2 cases, and sore throat in 2 cases. Twenty-six cases involved a single site, including 24 cases of the vocal cords, 1 case of the ventricular bands, and 1 case of the epiglottis; 5 cases involved multiple sites, including 2 cases of the vocal cords and the interarytenoid area, 2 cases of the aryepiglottic fold and the epiglottis, and 1 case of the aryepiglottic fold, the ventricular bands and the epiglottis. Eighteen patients showed a single morphology type under electronic laryngoscopy, including 4 cases of the edematous exudative type, 5 cases of the ulcerative type, and 9 cases of the granulation hyperplasia type. Edema, ulcer, and granulation hyperplasia can coexist and transit between each other. A total of 13 cases presented with two or more morphological types, with the edematous exudative type, the ulcerative type, and the granulation hyperplasia type occurred 7, 9, and 10 times respectively. Twenty-two patients had active or chronic pulmonary tuberculosis, while 9 patients had normal lung imaging. The laryngeal tissue biopsy pathology of 21 patients was chronic granuloma, and 10 patients were chronic granuloma with caseous necrosis; among them, 19 cases completed the Ziel-Neelsen staining (7 cases were positive for acid-fast bacilli), and 3 cases completed the polymerase chain reaction (PCR) (All were positive). Twenty cases completed the T-cell assay for tuberculosis infection (19 cases were positive), 15 cases completed the sputum smear (6 cases were positive), 18 cases were tested for antinuclear antibody (6 cases were positive), and 14 cases completed the erythrocyte sedimentation rate (4 cases were positive). Six patients underwent i-scan examination. In cases of ulcerative laryngeal tuberculosis without granulation hyperplasia in the surrounding tissues, i-scan revealed an abundance of abundant slightly thickened and tortuous oblique and dendritic blood vessels around the ulcer. If the pseudomembrane in the deep ulcer was thick, the blood vessel shadow was not visible. In shallow ulcers, there were areas of deep congestion and scattered dot-shaped blood vessel shadowst with uneven distribution; in cases of laryngeal tuberculosis with coexistence of the edematous exudative type and the granuloma type, i-scan visualized laryngeal cord edema with white exudates on the surface. Beneath the laryngeal cord exudates, there were scattered dot-shaped and irregularly distorted linear blood vessel shadows with uneven distribution, and tortuous, oblique, and dendritic blood vessels were observed around the lesion. In granuloma-type laryngeal tuberculosis, i-scan demonstrated that the area of granulation hyperplasia around the ulcer focus was significantly congested, characterized by scattered thick dot-shaped blood vessel shadows and irregularly distorted linear blood vessel shadows.Conclusions:Laryngeal tuberculosis presents as the edematous exudative type, the ulcerative type, and the granulation hyperplasia type under electronic laryngoscopy, and these types can coexist and interact. i-scan endoscopy can reveal detailed microvascular morphology and other subtle morphological characteristics. The identification and summary of these morphological characteristics are beneficial for the early detection and diagnosis of laryngeal tuberculosis.

OBJECTIVE: To evaluate effectiveness of proximal femur bionic nail (PFBN) in treatment of intertrochanteric fractures in the elderly compared to the proximal femoral nail antirotation (PFNA). METHODS: A retrospective analysis was made on 48 geriatric patients with intertrochanteric fractures, who met the selection criteria and were admitted between January 2020 and December 2022. Among them, 24 cases were treated with PFBN fixation after fracture reduction (PFBN group), and 24 cases were treated with PFNA fixation (PFNA group). There was no significant difference in baseline data such as age, gender, cause of injury, side and type of fracture, time from injury to operation, and preoperative mobility score, American Society of Anesthesiologists (ASA) score, Alzheimer's disease degree scoring, self-care ability score, osteoporosis degree (T value), and combined medical diseases between the two groups ( P>0.05). The operation time, intraoperative blood loss, number of blood transfusions, transfusion volume, length of hospital stay, occurrence of complications, weight-bearing time after operation, and postoperative visual analogue scale (VAS) score, walking ability score, mobility score, self-care ability score were recorded and compared between the two groups. And the radiographic assessment of fracture reduction quality and postoperative stability, and fracture healing time were recorded. RESULTS: The operations in both groups were successfully completed. All patients were followed up 6-15 months with an average time of 9.8 months in PFBN group and 9.6 months in PFNA group. The operation time was significantly longer in PFBN group than in PFNA group ( P<0.05), but there was no significant difference in intraoperative blood loss, number of blood transfusions, transfusion volume, length of hospital stay, change in activity ability score, and change in self-care ability score between the two groups ( P>0.05). The weight-bearing time after operation was significantly shorter in PFBN group than in PFNA group ( P<0.05), and the postoperative VAS score and walking ability score were significantly better in PFBN group than in PFNA group ( P<0.05). Radiographic assessment showed no significant difference in fracture reduction scores and postoperative stability scores between the two groups ( P>0.05). All fractures healed and there was no significant difference in fracture healing time between the two groups ( P>0.05). The incidence of complications was significantly lower in PFBN group (16.7%, 4/24) than in PFNA group (45.8%, 11/24) ( P<0.05). CONCLUSION Compared with PFNA, PFBN in the treatment of elderly intertrochanteric fractures can effectively relieve postoperative pain, shorten bed time, reduce the risk of complications, and facilitate the recovery of patients' hip joint function and walking ability.
Humans ; Aged ; Retrospective Studies ; Fracture Fixation, Intramedullary ; Bionics ; Blood Loss, Surgical ; Treatment Outcome ; Bone Nails ; Hip Fractures/surgery* ; Femur

Objective To investigate the relationships between the expression levels of tumor necrosis factor receptor associated factor 4 (TRAF4) and ribosomal S6 protein kinase 4 (RSK4) protein in gastric cancer tissues and the recurrence after laparoscopic radical gastrectomy. Methods In total, 176 patients were divided into the recurrence and non-recurrence group, and the expression levels of TRAF4 and RSK4 protein in cancer and adjacent tissues and in gastric cancer tissues in the recurrence and non-recurrence group were compared. The influencing factor of recurrence and the efficacy of TRAF4 and RSK4 protein expression in predicting recurrence were analyzed. Results The positive expression rate of TRAF4 protein in gastric cancer tissues was higher than that in adjacent tissues (P < 0.05) and that in the recurrence group was higher than that in the non-recurrence group (P < 0.05). The positive expression rate of RSK4 protein in gastric cancer tissues was lower than that in adjacent tissues (P < 0.05) and that in the recurrence group was lower than that in non-recurrence group (P < 0.05). The largest tumor diameter 5 cm, poor differentiation, TNM Ⅲ stage, depth of invasion T3-T4, lymph node metastasis, absence of adjuvant chemotherapy after operation, positive expression of TRAF4 and RSK4 protein, and regular diet w influenced the post-operative recurrence (all P < 0.05). The accuracy of TRAF4 and RSK4 protein in gastric cancer tissues in combined predicting the recurrence was 83.52%. Conclusion The expression of TRAF4 protein is high, and the RSK4 protein is low in gastric cancer tissue, which are related to recurrence.

【Objective】 To investigate the control rate of blood glucose and its influencing factors in type 2 diabetes mellitus patients in Yulin area. 【Methods】 We selected the adult type 2 diabetes patients who visited our hospital from May 2020 to December 2021 as the subjects. Then we collected their basic information (gender, age, household income, type of medical insurance payment, education level, and duration of disease), measured their height and weight, calculated their body mass index (BMI), detected HbA1c, and measured their subcutaneous and visceral fat. The Chi-square test and multivariate Logistic regression methods were used to analyze the influencing factors. 【Results】 The total attainment rate of HbA1c (HbA1c<7%) among 877 adults with type 2 diabetes was 13.34%. The Chi-square test showed that statistical differences in the attainment rate of HbA1c among different ages, family annual income, type of medical insurance, and duration of disease. Further unconditional multivariate Logistic regression analysis model results showed that the HbA1c attainment rate in 18-44 years old group was 0.418 times higher than that in ≥60 years old group (95% CI=0.219-0.799, P=0.008). The HbA1c compliance rate of patients with employees’ medical insurance was 1.744 times that those with residents’ medical insurance (95% CI=1.131-2.782, P=0.013). The HbA1c attainment rate of diabetic patients with an annual family income of 30 000 yuan to 100 000 yuan was 1.873 times (95% CI=1.074-3.266, P=0.027), and with an annual family income of more than 100 000 yuan was 2.649 (95% CI=1.299-5.404, P=0.007) times than that of diabetic patients with less than 30 000 yuan. 【Conclusion】 The blood glucose control rate in adults with type 2 diabetes mellitus in Yulin area is lower compared with the level of the nation and other regions. Age, annual household income, and type of medical insurance payment are independent influencing factors.

Objective:To investigate the characteristics and differences of anxiety, depression and sleep disorder among human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients in Guangzhou, then optimize the antiretroviral therapy and provide effective mental intervention.Methods:All HIV/AIDS patients from the outpatient department of Guangzhou Eighth People's Hospital were enrolled in the present study from January 2016 to December 2016. They were evaluated by the hospital anxiety and depression scale and Pittsburgh Sleep Quality Index, to analyze the levels of depression, anxiety and sleep disorder.Results:The incidences of anxiety, depression and sleep disorder were 30.5%(61/200), 31.0%(62/200) and 22.5%(45/200) respectively. 36.1%(22/61) of patients with anxiety and 35.5%(22/62) of patients with depression were accompanied by sleep disorder. The sleep disturbance index were significant higher in HIV/AIDS patients with anxiety ( t=4.065, P<0.001) or depression ( t=3.034, P=0.003) than those without anxiety or depression. Anxiety was mainly found in HIV/AIDS patients in aged 20 to 40 group ( F=7.998, P=0.018), while depression was mostly found in HIV/AIDS patients who didn't receive higher education ( F=13.55, P=0.001), and sleep disorder was more common in people with CD4 + count <200 cells/μl ( t=2.01, P=0.046). Conclusions:Anxiety and depression, which could aggravate sleep disorder, are very common in HIV/AIDS patients. Psychological care need to be strengthened to HIV positive patients in early phase, and screening questionnaires should be conducted before antiretroviral treatment began.

Objective:To observe the effectiveness of bone cement-enhanced proximal femoral nail antirotation (PFNA) in the treatment of severe osteoporotic intertrochanteric fracture.Methods:Between January 2016 and June 2017, 23 patients with severe osteoporotic intertrochanteric fracture were treated with bone cement-enhanced PFNA at Department of Orthopaedics, The Second Affiliated Hospital to Luohe Medical College. They were 9 men and 14 women with an average age of 85.3 years (range, from 80 to 91 years). According to AO/OTA-2018 classification, there were 2 cases of type 31-A1.3, 5 cases of type 31-A2.2, 13 cases of type 31-A2.3 and 3 cases of type 31-A3.3. According to Singh standard grading, 4 cases were rated as level 1, 16 cases as level 2 and 3 cases as level 3. The PFNA fixation was enhanced by bone cement in all. The operation time, amount of intraoperative bleeding, postoperative complications, fracture healing time and hip Harris scores at the last follow-up were recorded.Results:The operation time averaged 56.3 minutes (range, from 47 to 91 minutes) and the amount of intraoperative bleeding 197 mL (range, from 110 to 450 mL). All patients were followed up for 5 to 27 months (mean, 14.7 months). One patient who had been rated as good by the Harris hip score died 5 months after surgery because of acute suppurative obstructive cholangitis. All the 23 fractures achieved bony union. The healing time averaged 11.3 weeks (range, from 8 to 18 weeks). By the Harris scores at the last follow-up, 11 cases were excellent, 10 cases good and 2 cases fair, giving an excellent and good rate of 91.3%.Conclusion:Bone cement-enhanced PFNA can bring about good short-term outcomes for severe osteoporotic intertrochanteric fractures because it can improve the screw control and reduce the risk of internal fixation failure.

Objective: To explore the best surgical timing after neoadjuvant chemoradiation for advanced rectal cancer patients. Methods: According to the time interval between neoadjuvant chemoradiation and surgery, 117 patients with advanced rectal cancer were divided into short interval group (≤7 weeks, n=54) and long interval group (>7 weeks, n=64). The endpoints included postoperative pathology, short-term efficacy, tumor recurrence and patient survival between the two groups. Results: There were 8 cases PCR in short interval group and 20 cases in long interval group(P=0.415). There were 23 cases of T downgrade in short interval group and 40 cases in the long interval group, which has significant difference (P=0.039). There were 21 cases of N downgrade in short interval group and 38 cases in long interval group, which has significant different (P=0.033). The short-term group was effective in 28 cases, stable in 20 cases, and progressed in 5 cases. In short term efficacy comparison, the cases of complete response, stable disease and progressive disease in short interval group was 28 cases, 20 and 5, long interval group was 47 cases, 14 cases and 3 cases, which has no significant difference(P=0.068). The 3-year local recurrence rate of short interval group and long interval group was 17.0% and 4.7%, respectively, and the difference was statistically significant(P=0.029). The incidence of recurrence in 3 years of short interval group and long interval group was 64.2% and 79.7%, respectively, and the difference was not significant (P=0.061). The highest PCR rate was reached in the 10th and 11th week after neoadjuvant chemoradiotherapy. Of the 12 and 8 patients who underwent surgery, 3 (25.0%) and 2 (25.0%) achieved PCR, respectively. Conclusion PCR and local recurrence rate might be improved by time interval between neoadjuvant chemoradiation and surgery was more than 7 weeks.