Objective: To systematically evaluate the application effectiveness of the full disinfection process in blood stations, identify key optimization links, and provide a scientific evidence for the formulation of specialized disinfection and hygiene standards for blood collection and supply institutions. Methods: On-site microbiological monitoring was conducted using techniques such as the plate settling method and cotton swab method. Stratified random sampling was performed on eight key control points: including evironmental air, hand hygiene, skin disinfection, blood transport boxes, pressure steam sterilization, sewage treatment, ultraviolet disinfection, and sterile swabs. Statistical analysis was performed using SPSS 20.0. Measurement data were expressed as mean ± standard deviation(x-±s), and inter-group comparisons were conducted using t-tests or analysis of variance (ANOVA). Count data were expressed as rates, and inter-group comparisons were conducted using the χ test. Trend analysis was performed using the Cochran-Armitage test, with a significance level of α=0.05. Results: The colony removal rate of plasma air disinfection machines (94.2%±0.8%) was significantly higher than that of the ultraviolet group (P<0.05). The qualification rate of quick-drying disinfectant hand was 100% within 30 days after opening the bottle, but decreased to 93.3% after 40 days (P<0.01). The qualification rate of disinfection for blood transport boxes using 500 mg/L chlorine-containing disinfectant (100%) was significant higher 75% alcohol (60%, P< 0.05). Skin disinfection with 2% alcoholic chlorhexidine gluconate balanced effectiveness and user experience (satisfaction score 4.8±0.3). The qualification rates for core procedures such as pressure steam sterilization and sewage treatment were both 100%. Conclusion: The current disinfection procedures in blood collection and supply institutions are reliable. The effective usage period of hand disinfectants, disinfection methods for transport boxes, and usage duration of sterile swabs are the main points for optimization. It is recommended that the opened hand disinfectants be used for ≤30 days and that chlorine-containing disinfectants be prioritized for wiping transport boxes, providing empirical support for the revision of protocols and the formulation of standards.

Objective To analyze the research hotspots and trends of invasive fungal infections(IFIs)in China over the past 24 years,and provide references and suggestions for future research.Methods Literatures on IFIs re-search in China from 2000 to 2024 were retrieved from China National Knowledge Infrastructure(CNKI)and Web of Science(WOS).CiteSpace software was employed to conduct collaboration network analysis on authors' institu-tions,and co-occurrence,clustering,and burst analyses were conducted on key words.Results A total of 2 479 li-teratures retrieved from CNKI and 1 149 from WOS were included in the analysis,involving 295 research institu-tions,with no core research team identified having a intermediary centrality＞0.1.Institutions with intermediary centrality＞0.1 included Chinese Academy of Sciences,Peking University,Fudan University,Sun Yat-sen Univer-sity and Zhejiang University.Key words with high centrality included"diagnosis""risk factor""voriconazole"and"Candida albicans".Clustering analysis grouped the co-occurrence network of key words into 6 clusters,mainly covering fungal diagnosis,treatment,and susceptible factors.Since 2020,focuses on the safety of antifungal treat-ment agents and primary prevention have emerged,with hot topics including pharmacokinetics,children,clinical features,and risk factors.Conclusion Currently,research teams are dispersed with insufficient interdisciplinary collaboration.Research topics are relatively simple.It is necessary to strengthen research on fungal resistance and healthcare-associated infection prevention and control.Risk factors and prevention measures for IFIs may be the fo-cus of future research.

Radiochemotherapy-induced oral mucositis (OM) is a common oral complication in patients with tumors following head and neck radiotherapy or chemotherapy. Erosion and ulcers are the main features of OM that seriously affect the quality of life of patients and even the progress of tumor treatment. To date, differences in clinical prevention and treatment plans for OM have been noted among doctors of various specialties, which has increased the uncertainty of treatment effects. On the basis of current research evidence, this expert consensus outlines risk factors, clinical manifestations, clinical grading, ancillary examinations, diagnostic basis, prevention and treatment strategies and efficacy indicators for OM. In addition to strategies such as basic oral care, anti-inflammatory and analgesic agents, anti-infective agents, pro-healing agents, and photobiotherapy recommended in previous guidelines, we also emphasize the role of traditional Chinese medicine in OM prevention and treatment. This expert consensus aims to provide references and guidance for dental physicians and oncologists in formulating strategies for OM prevention, diagnosis, and treatment, standardizing clinical practice, reducing OM occurrence, promoting healing, and improving the quality of life of patients.
Humans ; Chemoradiotherapy/adverse effects* ; Consensus ; Risk Factors ; Stomatitis/etiology*

Objective To analyze the research hotspots and trends of invasive fungal infections(IFIs)in China over the past 24 years,and provide references and suggestions for future research.Methods Literatures on IFIs re-search in China from 2000 to 2024 were retrieved from China National Knowledge Infrastructure(CNKI)and Web of Science(WOS).CiteSpace software was employed to conduct collaboration network analysis on authors' institu-tions,and co-occurrence,clustering,and burst analyses were conducted on key words.Results A total of 2 479 li-teratures retrieved from CNKI and 1 149 from WOS were included in the analysis,involving 295 research institu-tions,with no core research team identified having a intermediary centrality＞0.1.Institutions with intermediary centrality＞0.1 included Chinese Academy of Sciences,Peking University,Fudan University,Sun Yat-sen Univer-sity and Zhejiang University.Key words with high centrality included"diagnosis""risk factor""voriconazole"and"Candida albicans".Clustering analysis grouped the co-occurrence network of key words into 6 clusters,mainly covering fungal diagnosis,treatment,and susceptible factors.Since 2020,focuses on the safety of antifungal treat-ment agents and primary prevention have emerged,with hot topics including pharmacokinetics,children,clinical features,and risk factors.Conclusion Currently,research teams are dispersed with insufficient interdisciplinary collaboration.Research topics are relatively simple.It is necessary to strengthen research on fungal resistance and healthcare-associated infection prevention and control.Risk factors and prevention measures for IFIs may be the fo-cus of future research.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To analyze the difference of maternal and neonatal outcomes for the living infant of surgically and spontaneously reduced dichorionic pregnancies following assisted reproductive technology (ART).Methods:We used a retrospective cohort study to analyze the clinical data of 11 050 fresh/frozen-thawed double embryos transfer with singleton live birth cycles in the Center for Reproductive Medicine of Jiangxi Maternal and Child Health Hospital from March 2014 to October 2021, including 226 cases in the surgical reduction group, 1 506 cases in the spontaneous reduction group, and 9 318 cases of singleton pregnancy in control group. The basic clinical data, maternal and fetal complications and birth outcomes of the three groups were compared by univariate analysis. Multivariate logistic regression was used to analyze the factors affecting maternal and infant outcomes.Results:The rate of premature rupture of membranes in the natural fetal reduction group, the surgical reduction group and control group was 1.4% (21/1 506), 1.3% (3/226) and 0.6% (56/9 318), respectively, with a significant difference among the three groups ( P=0.003). The differences of the risk of preterm birth, very premature birth, low birth weight, very low birth weight, and small for gestational age among the surgical fetal reduction group [17.3% (39/226), 4.0% (9/226), 15.5% (35/226), 3.1% (7/226), 9.3% (21/226)], the natural fetal reduction group [11.6% (175/1 506), 1.9% (28/1 506), 8.6% (129/1 506), 1.3% (20/1 506), 9.1% (137/1 506)] and control group [7.7% (721/9 318), 0.9% (86/9 318), 3.9% (367/9 318), 0.5% (45/9 318), 6.0% (560/9 318)] were statistically significant (all P<0.001). Compared with the spontaneous reduction group, the surgical reduction group had a higher risk of premature birth [(a OR=2.37, 95% CI: 1.64-3.42, P<0.001) vs. (a OR=1.54, 95% CI: 1.29-1.84, P<0.001)], very preterm birth [(a OR=4.26, 95% CI: 2.02-8.97, P=0.001) vs. (a OR=1.95, 95% CI: 1.26-3.01, P=0.003)], low birth weight [(a OR=4.35, 95% CI: 2.94-6.44, P<0.001) vs. (a OR=2.26, 95% CI: 1.83-2.79, P<0.001)] and small-for-gestational age[(a OR=1.82, 95% CI: 1.14-2.92, P=0.013) vs. (a OR=1.60, 95% CI: 1.31-1.95, P<0.001)]. There was no statistical difference in birth defect rate among the three groups ( P>0.05). Conclusion:The risk of maternal and fetal complications and birth defects for the living singletons of surgically and spontaneously reduced dichorionic diamniotic pregnancies were similar to those singleton pregnancies following ART, but the proportion of premature rupture of membranes is higher, and the risk of premature birth and low birth weight of surgical reduction were higher than that of spontaneous reduction. Surgical reduction is not recommended to use as a rescue measure of dichorionic twins conceived by ART.

Objective:To analyze the difference of maternal and neonatal outcomes for the living infant of surgically and spontaneously reduced dichorionic pregnancies following assisted reproductive technology (ART).Methods:We used a retrospective cohort study to analyze the clinical data of 11 050 fresh/frozen-thawed double embryos transfer with singleton live birth cycles in the Center for Reproductive Medicine of Jiangxi Maternal and Child Health Hospital from March 2014 to October 2021, including 226 cases in the surgical reduction group, 1 506 cases in the spontaneous reduction group, and 9 318 cases of singleton pregnancy in control group. The basic clinical data, maternal and fetal complications and birth outcomes of the three groups were compared by univariate analysis. Multivariate logistic regression was used to analyze the factors affecting maternal and infant outcomes.Results:The rate of premature rupture of membranes in the natural fetal reduction group, the surgical reduction group and control group was 1.4% (21/1 506), 1.3% (3/226) and 0.6% (56/9 318), respectively, with a significant difference among the three groups ( P=0.003). The differences of the risk of preterm birth, very premature birth, low birth weight, very low birth weight, and small for gestational age among the surgical fetal reduction group [17.3% (39/226), 4.0% (9/226), 15.5% (35/226), 3.1% (7/226), 9.3% (21/226)], the natural fetal reduction group [11.6% (175/1 506), 1.9% (28/1 506), 8.6% (129/1 506), 1.3% (20/1 506), 9.1% (137/1 506)] and control group [7.7% (721/9 318), 0.9% (86/9 318), 3.9% (367/9 318), 0.5% (45/9 318), 6.0% (560/9 318)] were statistically significant (all P<0.001). Compared with the spontaneous reduction group, the surgical reduction group had a higher risk of premature birth [(a OR=2.37, 95% CI: 1.64-3.42, P<0.001) vs. (a OR=1.54, 95% CI: 1.29-1.84, P<0.001)], very preterm birth [(a OR=4.26, 95% CI: 2.02-8.97, P=0.001) vs. (a OR=1.95, 95% CI: 1.26-3.01, P=0.003)], low birth weight [(a OR=4.35, 95% CI: 2.94-6.44, P<0.001) vs. (a OR=2.26, 95% CI: 1.83-2.79, P<0.001)] and small-for-gestational age[(a OR=1.82, 95% CI: 1.14-2.92, P=0.013) vs. (a OR=1.60, 95% CI: 1.31-1.95, P<0.001)]. There was no statistical difference in birth defect rate among the three groups ( P>0.05). Conclusion:The risk of maternal and fetal complications and birth defects for the living singletons of surgically and spontaneously reduced dichorionic diamniotic pregnancies were similar to those singleton pregnancies following ART, but the proportion of premature rupture of membranes is higher, and the risk of premature birth and low birth weight of surgical reduction were higher than that of spontaneous reduction. Surgical reduction is not recommended to use as a rescue measure of dichorionic twins conceived by ART.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.

OBJECTIVE: To investigate the regulatory effect and mechanism of DNA methyltransferase 3A (DNMT3a) in hydroquinone-induced hematopoietic stem cell toxicity. METHODS: Cells (HSPC-1) were divided into 4 groups, that is A: normal HSPC-1; B: HQ-intervented HSPC-1; C: group B + pcDNA3 empty vector; D: group B + pcDNA3- DNMT3a. RT-qPCR and Western blot were used to detect the expression levels of DNMT3a and PARP-1 mRNA and protein, respectively. Cell morphology was observe; Cell viability and apoptosis rate of HSPC-1 were detected by MTT and flow cytometry, respectively. RESULTS: Compared with group A, the expression levels of DNMT3a mRNA and protein in HSPC-1 of group B were decreased, while PARP-1 mRNA and protein were increased (P<0.05); there was no significant difference in the above indexes between group C and group B; compared with group B, the expression levels of DNMT3a mRNA and protein showed increased, while PARP-1 mRNA and protein were decreased significantly in cells of group D transfected with DNMT3a (P<0.05). Cells in each group were transfected with DNMT3a and cultured for 24 h, HSPC-1 in group A showed high density growth and mononuclear fusion growth, while the number of HSPC-1 in group B and C decreased and grew slowly. Compared with group B and C, the cell growth rate of group D was accelerated. The MTT analysis showed that cell viability of HSPC-1 in group B were lower than that of group A at 24 h, 48 h and 72 h (P<0.05); after transfected with DNMT3a, the cell viability of HSPC-1 in group D were higher than that of group B at 24 h, 48 h and 72 h (P<0.05). The apoptosis rate of cells in group B was significantly higher than that of group A (P<0.001), while the apoptosis rate in group D was lower than that of group B (P<0.001). CONCLUSION DNMT3a may be involved in the damage of hematopoietic stem cells induced by hydroquinone, which may be related to the regulation of PARP-1 activity by hydroquinone-inhibited DNMT3a.
Apoptosis ; Cell Proliferation ; DNA Methyltransferase 3A ; Hematopoietic Stem Cells/drug effects* ; Humans ; Hydroquinones/toxicity* ; Poly (ADP-Ribose) Polymerase-1 ; RNA, Messenger/metabolism*

ObjectiveTo investigate effect of conducting training of autism spectrum disorder （ASD） early screening skill on improving the ability to early identify ASD of medical staffs in primary care hospitals. MethodsIn September 2021， the training of ASD early screening skills was carried out for medical staffs from 20 primary care hospitals in Chengdu. After training， the training effect was evaluated. The numbers of referrals from primary care hospitals to superior hospitals， confirmed ASD as well as their average diagnostic age of children with ASD before and after training were used as evaluation indicators. ResultsAfter training， the number of children with suspected ASD referred by primary care hospitals was more than that before training ［（16.65±11.60） vs. （3.40±2.23）， t=5.431， P<0.01］， the number of children diagnosed with ASD was more than that before training［（6.85±4.93） vs. （2.45±1.67）， t=4.171， P<0.01］， and the differences were statistically significant. As for the diagnosed age of ASD children， after training， the average age was lower than that before training ［（34.95±11.67） vs. （42.2±14.64）， t=-2.553， P=0.019］. ConclusionTraining of ASD early screening skills for medical staffs in primary care hospitals may help to improve their ability to early screening ASD children.