OBJECTIVE To quantitatively evaluate the effect on decolonization of gram-negative bacteria(GNB)and carbapenem-resistant gram-negative bacteria(CRGNB)in water sinks of neonatal wards and compare the decoloni-zation effects among the 500 mg/L,1000 mg/L of chlorine-containing disinfectants and 3％hydrogen peroxide so-lution.METHODS A total of 15 water sinks were chosen from West China Second University Hospital of Sichuan University as the research subjects,which were randomly divided into the 500 mg/L chlorine-containing disinfect-ant group,the 1000 mg/L chlorine-containing disinfectant group and the 3％hydrogen peroxide solution group.The bacterial colony counts of GNB and CRGNB as well as microbial diversity at the drain outlets were ob-served and compared before the intervention and after the disinfectants were continuously poured for 7 days.RESULTS There were GNB and CRGNB colonized at the drain outlets of water sinks in the neonatal wards under the mode of regular rinsing with 500 mg/L of chlorine-containing disinfectant,with Pseudomonadaceae dominant.There were no significant differences in the bacterial colony counts of GNB/CRGNB,Alpha diversity(Shannon index)and Beta diversity(Bray-Curtis distance)among the three types of disinfectants after the inter-vention for 7 days.CONCLUSIONS There are still large quantity of GNB and CRGNB colonized at the drain outlets of water sinks of neonatal wards after daily conventional treatment with 500 mg/L of chlorine-containing disinfect-ant.Neither the disinfectant with the concentration of chlorine increasing to 1000 mg/L nor 3％hydrogen peroxide solution can remarkably reduce the colonization or alter the microbial diversity.The optimal disinfection strategy should be formulated based on compound disinfectant,physical intervention and project reconstruction.

OBJECTIVE To quantitatively evaluate the effect on decolonization of gram-negative bacteria(GNB)and carbapenem-resistant gram-negative bacteria(CRGNB)in water sinks of neonatal wards and compare the decoloni-zation effects among the 500 mg/L,1000 mg/L of chlorine-containing disinfectants and 3％hydrogen peroxide so-lution.METHODS A total of 15 water sinks were chosen from West China Second University Hospital of Sichuan University as the research subjects,which were randomly divided into the 500 mg/L chlorine-containing disinfect-ant group,the 1000 mg/L chlorine-containing disinfectant group and the 3％hydrogen peroxide solution group.The bacterial colony counts of GNB and CRGNB as well as microbial diversity at the drain outlets were ob-served and compared before the intervention and after the disinfectants were continuously poured for 7 days.RESULTS There were GNB and CRGNB colonized at the drain outlets of water sinks in the neonatal wards under the mode of regular rinsing with 500 mg/L of chlorine-containing disinfectant,with Pseudomonadaceae dominant.There were no significant differences in the bacterial colony counts of GNB/CRGNB,Alpha diversity(Shannon index)and Beta diversity(Bray-Curtis distance)among the three types of disinfectants after the inter-vention for 7 days.CONCLUSIONS There are still large quantity of GNB and CRGNB colonized at the drain outlets of water sinks of neonatal wards after daily conventional treatment with 500 mg/L of chlorine-containing disinfect-ant.Neither the disinfectant with the concentration of chlorine increasing to 1000 mg/L nor 3％hydrogen peroxide solution can remarkably reduce the colonization or alter the microbial diversity.The optimal disinfection strategy should be formulated based on compound disinfectant,physical intervention and project reconstruction.

Humans ; Alzheimer Disease ; Cross-Sectional Studies ; Creatine Kinase ; Brain/metabolism*

Objective:To summarize long-term clinical follow-up results of segment instability between the upper instrumented vertebra (UIV) and the adjacent upper vertebra (UIV+1) and to establish the optimal timing for surgery for UIV+1.Methods:A retrospective analysis was conducted on 265 patients with lumbar degenerative diseases who underwent transforaminal lumbar interbody fusion (TLIF) surgery at the Department of Spinal Surgery, Zhongda Hospital, from January 2014 to December 2018. The cohort included 119 male and 146 female patients, with an average age of 64.93 years (range: 32-86 years). Preoperative dynamic imaging measured sagittal angulation (SA) and sagittal translation (ST) of the UIV+1/UIV segment. Patients with SA>10° or ST>2 mm were categorized into the unstable group, further divided into the unstable non-fusion group and the unstable fusion group based on whether UIV+1 expansion fusion was performed. The remaining patients were classified into the stable group. Imaging indicators, Visual Analogue Scale (VAS) scores, Oswestry disability index (ODI) scores, and Japanese Orthopaedic Association (JOA) scores were compared among the groups, with JOA improvement rates calculated to assess clinical efficacy. Pearson correlation coefficient analysis was employed to examine correlations between preoperative imaging indicators and final follow-up JOA improvement rates. Receiver Operating Characteristic (ROC) curves and the maximum Youden index were utilized to determine thresholds for preoperative SA and ST.Results:The follow-up duration for all patients was 73.53±12.92 months (range: 61-108 months). The stable group (124 cases) included 61 males and 63 females, aged 64.31±9.83 years (range: 44-82 years). The unstable non-fusion group (59 cases) included 22 males and 37 females, aged 65.76±11.01 years (range: 32-86 years). The unstable fusion group (82 cases) included 36 males and 46 females, aged 65.26±8.68 years (range: 47-80 years). At the last follow-up, the unstable non-fusion group exhibited ΔSA 0.90°±1.97° and ΔST 0.77±1.27 mm, both significantly higher than the stable group's ΔSA 0.25°±1.57° and ΔST 0.34±0.34 mm ( t=3.564, P<0.001; t=2.311, P=0.022). Clinical improvements were lower in the unstable non-fusion group compared to the other two groups: VAS (2.28±0.83), ODI (5.91%±3.46%), JOA (24.11±1.78), with a JOA improvement rate of 60%. The stable group showed VAS (1.51±0.69), ODI (3.71%±1.75%), JOA (27.33±1.91), with a JOA improvement rate of 83%. The unstable fusion group had VAS (1.46±0.83), ODI (3.46%±1.81%), JOA (26.48±1.66), with a JOA improvement rate of 78%. These differences were statistically significant ( F=32.117, P<0.001; F=24.827, P<0.001; F=92.658, P<0.001; F=93.341, P<0.001). The JOA improvement rate was negatively correlated with preoperative SA ( r=-0.363, P<0.001) to a low extent, and with preoperative ST ( r=-0.596, P<0.001) to a moderate extent. ROC curve analysis determined the preoperative SA threshold as 11.5° and the preoperative ST threshold as 1.85 mm. Conclusion:Pre-existing instability of the responsible segment UIV and UIV+1 (SA>10° or ST>2 mm) may worsen during long-term follow-up after TLIF. When preoperative SA exceeds 11.5° and ST exceeds 1.85 mm between UIV and UIV+1, performing an extended fusion involving UIV+1 can ensure surgical efficacy over long-term follow-up.

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.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.