Objective:To design a vest-type breast dressing bra and explore its application effect in the external application of traditional Chinese medicine therapy for patients with granulomatous lobular mastitis(GLM).Methods:A randomized controlled study was conducted, utilizing convenience sampling to select female patients with 122 GLM who underwent their first topical medication treatment in the Breast Department of Guangdong Provincial Hospital of Traditional Chinese Medicine between January and May 2023. The patients were divided into a control group and an observation group, with 61 patients in each, using a random number table. Following medication application, patients in the control group used a regular sports bra to secure the medication, while patients in the observation group used a custom-designed vest-style breast medication bra for the same purpose. Three hours after the intervention, comparisons were made between the two groups in terms of the incidence of medication detachment, medication displacement, clothing contamination, patient satisfaction, and safety.Results:Both groups of patients completed the study. The age of the observation group was (32.18 ± 5.50) years old, while the age of the control group was (33.66 ± 5.20) years old. Three hours after the intervention, the incidence of medication detachment, medication displacement, clothing contamination in the observation group were 3.28% (2/61), 6.56% (4/61), and 8.20% (5/61), which were lower than those in the control group with 18.03% (11/61), 26.23% (16/61), and 67.21% (41/61), respectively. The differences were statistically significant ( χ2=6.97, 8.61, 45.23; all P<0.05). The satisfaction level of patients towards the bra in the observation group was (4.43 ± 0.85) points, higher than that of the control group (3.85 ± 1.08) points, with a statistically significant difference ( t=3.30, P<0.05). The incidence rates of skin allergic reactions were 3.28%(2/61) and 4.92%(3/61) in the observation group and the control group, respectively, with no statistically significant difference ( P>0.05). Conclusions:The vest-type breast dressing bra designed in this study can properly secure the medicinal paste, reduce the rate of medication detachment, medication displacement, clothing contamination, and enhance patient satisfaction. It facilitates the external application of traditional Chinese medicine for patients with GLM and is worthy of clinical promotion.

Objective:To retrospectively evaluate the clinical efficacy and safety of total 3D laparo-scopic ileal ureters replacement for bilateral ureters combined with bladder augmentation in patients with post-radiotherapy long-segment bilateral ureteral strictures and contracted bladder.Methods:Clinical data of two patients(aged 72 and 54 years)with radiation-induced long-segment bilateral ureteral stric-tures and reduced bladder capacity,treated at the Sixth Affiliated Hospital of Jinan University from Octo-ber 2023 to June 2024,were analyzed.Both presented with bilateral flank pain,recurrent chills/fever,urinary frequency,and urgency.Preoperative ureteral stricture lengths were measured as follows:left 10.4 cm and right 8.7 cm in the first case;left 10.6 cm and right 11.7 cm in the second case.Bladder capacity assessed by nephrostomy-assisted antegrade urography was 90 mL and 130 mL respectively.Both underwent single-position,one-stage totally 3D laparoscopic bilateral ileal ureteral replacement and blad-der augmentation based on membrane anatomy principles,with regular postoperative follow-up.Results:Procedures were completed by the same experienced urologist.Operative times were 420 min and 355 min,with intraoperative blood loss of 50 mL(no transfusion required).Postoperative bowel function re-sumed at the end of 4.5 and 3 days.No major perioperative complications occurred.Ureteral stents were removed at 2 months postoperatively,with imaging showing improved hydronephrosis,unobstructed ure-teral drainage,symmetrical bladder morphology,and smooth walls.Postoperative bladder capacities were 230 mL and 250 mL.Follow-up durations were 10 and 8 months.Both patients experienced significant relief of flank pain and lower urinary tract symptoms.No complications(enteric fistula,urinary fistula,or metabolic acidosis)were observed.At the final follow-up,one patient had mildly elevated serum cre-atinine,while the other showed reduced levels compared with preoperative values;both remained stable.Conclusion:Membrane anatomy-based dissection facilitates safe mobilization of fibrotic ureters with mini-mal bleeding and collateral damage.Total intracorporeal 3D laparoscopic ileal ureters replacement for bi-lateral ureters combined with bladder augmentation effectively addresses long-segment ureteral obstruction and improves bladder capacity.This approach is technically safe and feasible,though further validation with larger clinical cohorts is warranted.

Objective To evaluate the effect of bundle intervention on reducing catheter-associated urinary tract in-fection(CAUTI).Methods Hospitalized patients with urinary catheterization in a tertiary first-class hospital were subjected to targeted monitoring of a baseline survey from January to December 2022(pre-intervention).The main causes were found out,and bundle intervention measures were developed and implemented through plan-do-check-act(PDCA)tools from January to March 2023(intervention period).The data from April to December 2023(post-intervention)were collected,difference in catheter use rate and incidence of CAUTI before and after intervention were compared.Results The implementation rate of correctly hanging urine collection bags after intervention was 97.00％,the implementation rate of timely emptying urine collection bags was 91.72％,awareness rate of hand hy-giene among patient's family members was 79.13％,implementation rate of urinary catheter clamping during trans-portation was 74.79％,and daily evaluation implementation rate was 87.68％,which were higher than the pre-in-tervention rates of 85.63％,80.47％,62.75％,60.00％,and 79.93％,respectively.The incidence of CAUTI de-creased from 1.23‰ before intervention to 0.57‰ after intervention,the use rate of urinary catheter decreased from 5.53％before intervention to 5.37％after intervention.Differences of the above indicators were all statistically sig-nificant(all P＜0.05).Conclusion Through targeted monitoring on CAUTI and PDCA quality tools,the weak links in healthcare-associated infection control are identified,more targeted prevention and control measures are for-mulated,the implementation of bundle intervention measures can reduce the incidence of CAUTI.

Objective To explore the factors influencing blood drug concentrations of first-line anti-tuberculosis drugs in fixed-dose combinations by analyzing therapeutic drug monitoring data from tuberculosis patients receiving these regimens.Methods This retrospective study enrolled 224 patients who received treatment at Guangzhou Chest Hospital between January 2020 and December 2024.All participants underwent standardized therapy during the intensive phase,with therapeutic drug monitoring of first-line anti-tuberculosis drugs(ANTDs),including isoniazid(INH)and rifampicin(RFP).Data collection was completed in January 2025,at which time clinical records and measured INH and RFP plasma concentrations were updated.Data analysis was conducted from January to February 2025.Eight baseline variables—gender,age,hypoproteinemia(serum albumin<35 g/L),glomerular filtration rate(GFR),and others—were collected.Univariate chi-square tests and multivariate logistic regression analyses were performed to identify independent risk factors associated with subtherapeutic INH and RFP plasma concentrations.Results Among the study participants,71.43%(160/224)exhibited blood drug concentrations below the reference range for INH,compared to 41.07%(92/224)for RFP.The mean blood concentrations(mg/L,±SD)were 2.532±1.371 for INH and 9.428±4.317 for RFP,respectively.One-way analysis indicated significant associations between male gender,positive etiological test results,and subtherapeutic RFP concentrations(P<0.05),suggesting statistically significant differences.Multivariate regression analysis further revealed that male gender(OR=1.992,95%CI:1.094～3.628)and positive etiological tests(OR=1.929,95%CI:1.058～3.517)were independent risk factors for low RFP levels.Conclusions This study demonstrates that therapeutic drug monitoring(TDM)frequently identifies subtherapeutic RFP concentrations in tuberculosis patients undergoing treatment.Multivariate analysis reveals that male sex and positive pathogen test results are independent risk factors associated with low RFP plasma levels.Consequently,clinicians should exercise heightened vigilance in patients exhibiting these characteristics,promptly implementing TDM to guide individualized dose adjustments.Such an approach is crucial for optimizing treatment efficacy and minimizing the risk of drug resistance development.

Objective To compare the diagnostic performance of two syphilis reverse testing protocols recommended by the U.S.Centers for Disease Control and Prevention(USCDC)and the European Centre for Disease Prevention and Control(ECDC)within maternal and child populations,and to explore the factors contributing to false-positive results in chemiluminescent immunoassays(CLIA).Methods A retrospective analysis was performed on serological test results from 109,003 patients collected between 2021 and 2023.All participants were initially screened for specific syphilis antibodies using CLIA,and those with positive results underwent confirmatory testing with both the toluidine red unheated serum test(TRUST)and the Treponema pallidum particle agglutination assay(TPPA).The kappa statistic was employed to assess the diagnostic agreement between the USCDC and ECDC protocols,while also analyzing the distribution patterns of CLIA false-positive results across varying S/CO value ranges and demographic groups.Results Both protocols achieved a syphilis positivity rate of 0.34%.The hospital's high-prevalence syphilis screening program identified no cases with CLIA-positive or TRUST-positive but TPPA-negative results,suggesting high specificity in this population.The two protocols demonstrated perfect agreement with a Kappa value of 1.0,indicating no significant difference in diagnostic performance between maternal and child populations.CLIA exhibited a true positive rate of 71.04%,which was positively correlated with S/CO values:21.88%when 1.010.The highest false positive rate for CLIA(38.75%)was observed among young adults,while the largest proportion of false positives-reaching 40.00%—was associated with pregnancy and abortion status.Conclusions The two reverse detection methods for syphilis exhibit comparable diagnostic efficacy in women and children from populations with low syphilis prevalence.CLIA demonstrates high sensitivity;however,when the S/CO ratio is less than 10,particularly in adult women of childbearing age,clinicians should remain vigilant for potential false-positive results to prevent misdiagnosis and unnecessary medical interventions.