Critically ill patients are at high risk for hospital acquired infections, which can significantly increase the mortality rate and treatment costs for these patients. Therefore, in the process of treating the primary disease, strict prevention and control of new hospital infections is an essential component of the treatment for critically ill patients. The treatment of critically ill patients involves multiple steps and requires a concerted effort from various aspects such as theory, management, education, standards, and supervision to achieve effective prevention and control of hospital infections. However, there is currently a lack of unified understanding and standards for hospital infection prevention and control. To address this, in March 2024, a group of experts in critical care medicine, infectious diseases, and hospital infection from China discussed the current situation and issues of hospital infection control in the intensive care unit together. Based on a review of the latest evidence-based medical evidence from both domestic and international sources, 2024 Expert Consensus on Hospital Acquired Infection Control Principles in the Department of Critical Care Medicine was formed, aiming to provide a basis for the development of hospital infection prevention and control strategies in the field of critical care medicine.

Objective To explore the mortality rate and changes in splenic cell cycle and apoptosis in rats with ab-dominal infection.Methods An animal model of sepsis was induced by cecal ligation and puncture(CLP)in rats.At serial time points 0 h,6 h,12 h,24 h,48 h,and 72 h after CLP,the animal death rate was calculated.The percentage of cell cycle G1,S,G2/M phase and apoptosis of isolated spleen cells were analyzed using flow cytome-ter.The expression of p27 of spleen tissue was determined by Western blot analysis.Results In the rat model of CLP-induced systemic inflammatory response,the mortality of animals gradually increased at 0 h,6 h,12 h,24 h,48 h and 72 h after CLP surgery,reaching a maximum of 88.81%.The abdominal infection in the animals gradual-ly worsened at 0 h,6 h,12 h,and 24 h after CLP surgery,but localized and gradually alleviated after 48 h and 72 h.Within 48 h after CLP surgery,there was a blockage in the G1 phase of the spleen cell cycle,an increase in the percentage of apoptotic cells,and an elevation in p27 expression.After 48 h,the G1 phase blockage gradually recovered,the number of apoptotic cell decreased,and p27 expression declined.Additionally,with-in 48 h after CLP surgery,there was a decrease in the percentage of cells in the S and G2/M phases of the spleen cell cycle,but the percentage of cells in these phases gradually increased after 48 h.Conclusions Cell cycle arrest and apoptosis of the spleen cells are potentially contributed to the change of animal mortality after abdominal infection.

Objective To observe effect of TCM oral care solution in patients with gingival bleed-ing caused by oral administration of warfarin.Methods A total of 150 hospitalized patients in the car-diology department were selected as study objects,and were randomly divided into control group 1,control group 2 and experimental group,with 50 patients per group.Patients in the three groups were given medication care of warfarin and health guidance for mouth care.The control group 1 increased the use of normal saline gargle;the control group 2 increased the use of silver ion gargle,and the ex-perimental group was given the use of traditional Chinese medicine oral care solution gargle.After the intervention,the number of gingival bleeding,gingival sulcus bleeding index(SBI)and halitosis score in the three groups were compared.Results The number of gingival bleeding during gargling(10 d)and within 4 weeks after discharge in the experimental group were less than that in the control group 1 and control group 2,the difference was statistically significant(P＜0.05).The SBI of the experimen-tal group was(1.53±0.69),which was lower than(2.12±0.79)in the control group 1 and(2.09± 0.76)in the control group 2(P＜0.05).The score of halitosis during gargling in the experimental group was(1.70±0.68),which was lower than(2.28±0.74)in the control group 1 and(2.23± 0.79)in the control group 2(P＜0.05).Conclusion The TCM oral care solution for patients with gingival bleeding caused by oral administration of warfarin can significantly reduce the number of gingi-val bleeding,reduce SBI,alleviate bad breath,improve oral health and drug safety.

Objective To observe effect of TCM oral care solution in patients with gingival bleed-ing caused by oral administration of warfarin.Methods A total of 150 hospitalized patients in the car-diology department were selected as study objects,and were randomly divided into control group 1,control group 2 and experimental group,with 50 patients per group.Patients in the three groups were given medication care of warfarin and health guidance for mouth care.The control group 1 increased the use of normal saline gargle;the control group 2 increased the use of silver ion gargle,and the ex-perimental group was given the use of traditional Chinese medicine oral care solution gargle.After the intervention,the number of gingival bleeding,gingival sulcus bleeding index(SBI)and halitosis score in the three groups were compared.Results The number of gingival bleeding during gargling(10 d)and within 4 weeks after discharge in the experimental group were less than that in the control group 1 and control group 2,the difference was statistically significant(P＜0.05).The SBI of the experimen-tal group was(1.53±0.69),which was lower than(2.12±0.79)in the control group 1 and(2.09± 0.76)in the control group 2(P＜0.05).The score of halitosis during gargling in the experimental group was(1.70±0.68),which was lower than(2.28±0.74)in the control group 1 and(2.23± 0.79)in the control group 2(P＜0.05).Conclusion The TCM oral care solution for patients with gingival bleeding caused by oral administration of warfarin can significantly reduce the number of gingi-val bleeding,reduce SBI,alleviate bad breath,improve oral health and drug safety.

【Objective】 To perform electrochemiluminescence immunoassay (ECLIA) and Western blotting (WB) confirmation tests for HIV reactive samples in blood screening, and analyze the correlation between ELISA (enzyme-linked immunosorbent assay), ECLIA results and confirmed infection, so as to provide data support for the application of ECLIA in blood screening. 【Methods】 177 HIV reactive samples in blood screening testing detected by our laboratory from February to October 2019 were collected, of which 137 were reactiv to isolated ELISA reagent e, 39 to dual ELISA reagent, and 1 in window period. Ten maker-negative samples were randomly selected to undergo ECLIA with the above 177 samples. HIV reactive samples were sent to Centers for Disease Control and Prevention (CDC) for confirmation tests, and the results were analyzed and compared. 【Results】 Among the 177 HIV reactive samples, 66 were ECLIA reactive, 111 negative, and the 10 maker-negative samples remained negative. The sensitivity, specificity, positive predictive value, negative predictive value and total concordance rate of ECLIA were 97.1%, 81.1%, 55%, 99.1% and 84.2%, respectively, showing better performance than that of two ELISA reagents(P<0.05) with exception of sensitivity(P>0.05). The positive predictive value and specificity were tested by chi-square test, and the difference between ECLIA and reagent 2 was statistically significant (P<0.05). The ECLIA results showed significant correlation with the confirmation results with good consistency(examed by Kappa test). Among the three reagents, ECLIA presented highest accuracy and largest Youden index. 【Conclusion】 ECLIA presents high detection sensitivity, which can improve the detection ability of early HIV infection and shorten the window period of HIV detection, therefore should be popularized in blood screening.

【Objective】 To establish deferral criterion of HIV ELISA (enzyme-linked immunosorbent assay) and electrochemiluminescence immunoassay(ECLIA) by using receiver operating characteristic curve(ROC) method to screen HIV reactive blood donors suitable for entering the re-entry process and improve the management efficiency of reactive blood donors. 【Methods】 The test results of 92 001 blood donors from February to September 2019 were analyzed, and 177 reactive samples were screened by conventional screening mode (twice ELISA and once nucleic acid), supplemented with electrochemiluminescence immunoassay assay (ECLIA), and confirmed by Western blotting (WB). Screening reactive samples were divided into three groups: group A was both serological and nucleic acid reactivity, group B was only serological reactive, and group C was only nucleic acid reactivity. Its efficacy in blood donor classification was assessed by drawing ROC curves with 99% specific corresponding S/CO low values as the deferral criterion of the corresponding serological method. 【Results】 1) A total of 177 HIV reactive samples were detected in conventional mode, including 34 in group A, 142 in Group B and 1 in Group C. The positive predictive value (PPV) was 100%, 0.75% and 100%, respectively. ECLIA detection mode (once ECLIA and once NAT), a total of 67 HIV reactive samples including 34 in group A, 32 in group B and 1 in group C, with positive predictive values of 100%, 3.7% and 100%, respectively.2) The HIV test results showed diversity, with 36 true positive samples including 1 HIV elite controller and 3 early HIV infections (1 HIV ELISA antigen/antibody window and 2 ELISA HIV antibody window), and 32 serological and NAT cases were reactive infections.3) The deferral limit of ELISA 1 and ELISA 2 in conventional screening mode were 20.25 and 9.85, respectively, can screen 97.14% (34/35) of all true positive samples in group A and B, except for one ELISA HIV antibody window (ELISA 2 reactivity). The positive predictive values were 93.94% and 92.85%, respectively. The ECLIA deferral limit of 7.83 can screens all true positive samples in Groups A and B (35/35)in ECLIA mode. The positive predictive value was 94.59%. 【Conclusion】 The establishment of deferral limits in this study can effectively screen HIV-positive blood donors, and the number of screened blood donors is greatly reduced, which is helpful to fine and scientific management of HIV-reactive blood donors. The deferral limit values of different testing reagents are quite different, so each laboratory should choose appropriate testing methods to establish the deferral limit values suitable for the laboratory according to its own testing ability, so as to provide technical support for optimizing the process of returning blood donors to the team.

A 48-year-old woman was vaccinated with quadrivalent lytic influenza virus vaccine. Seven days later, tenderness pain and mass with tenderness pain appeared on the left side of the thyroid gland, which was diagnosed as subacute thyroiditis. The patient received celecoxib capsules 200 mg orally twice daily, external application of Pingying powder (平瘿散), and oral administration of traditional Chinese medicine decoction. The pain and mass disappeared after 21 days of treatments. One week later, similar symptoms occurred on the right side of the thyroid gland, the same dose of celecoxib capsules was given, but it was ineffective. So, it was replaced by prednisone acetate tablets 20 mg orally once daily. Twenty-five days later, the pain was relieved and the neck mass reduced. It was considered that the patient′s subacute thyroiditis was possibly due to quadrivalent lytic influenza virus vaccine.

A 48-year-old woman was vaccinated with quadrivalent lytic influenza virus vaccine. Seven days later, tenderness pain and mass with tenderness pain appeared on the left side of the thyroid gland, which was diagnosed as subacute thyroiditis. The patient received celecoxib capsules 200 mg orally twice daily, external application of Pingying powder (平瘿散), and oral administration of traditional Chinese medicine decoction. The pain and mass disappeared after 21 days of treatments. One week later, similar symptoms occurred on the right side of the thyroid gland, the same dose of celecoxib capsules was given, but it was ineffective. So, it was replaced by prednisone acetate tablets 20 mg orally once daily. Twenty-five days later, the pain was relieved and the neck mass reduced. It was considered that the patient′s subacute thyroiditis was possibly due to quadrivalent lytic influenza virus vaccine.

Objective To establish a method of quick three-dimensional (3D) reconstruction of pubic symphysis based on magnetic resonance imaging. Methods The pelvis images of adult male were generated on a 3.0 T scanner using a T1 Gradient Echo FLASH-3D (T1- FL3D) sequence and imported the images into medical image control system. Segmentation of binaryzation threshold was conducted and pelvic soft tissue image was extracted by regional growth, 3D structure model of pubic symphysis was obtained by Boolean operation. The 3D structure model of pubic symphysis was established by the noise reduction of reverse engineering software. And compared with the 3D reconstruction model pubic bone CT scan. Results The morphological characters of the MRI pubic symphysis 3D model, such as the ridges and furrows on the symphysial surface, lower extremity, dorsal margin (beveling), margin (beveling) and pubic tubercle, were highly consistent with the morphological characters of the 3D model established by CT scan. Conclusion MRI scan can be used to reconstruct the 3D structure of pubic symphysis quickly and effectively, and it can provide a safe radiation-free 3D visualization imaging technique for forensic age estimation for the living.

Objective To study the clinical efficiency and possible side effects of lower tidal volume combined with sustained inflation(SI) on acute respiratory distress syndrome (ARDS) for post operative carcinoma surgery patients.Methods Fifty one hypoxemia post operative carcinoma surgery patients from Jan.2007 to Dec.2009 in Cancer Hospital and Institute,Chinese Academy of Medical Sciences and Peking Union Medical College were included.Their cirrculation was stable.Mechanical ventilation could not be removed due to ARDS.Noninvasive continuous artery blood pressure ( NBP),pulse oximetric saturation ( SPO2 ),arterial blood gas ( ABG ) analysis,static compliance of respiratory system (Cst) were monitored and recorded.Patients were ventilated on volume control mode.Tidal volumes (VT) was set to 6 ml/kg.SI were conducted by continuous positive airway pressure of 35 cm H2O,sustaining for 40 seconds.Positive end-expiratory pressure (PEEP),FiO2,respiratory rate (F),Pplateau inspiratory pressures (Pplat),the peak inspiratory pressures (Ppeak),VT,Cst and ABG before SI applying and at 10 min,24 h,48 h after SI applying were measured.Results The level of PaO2 and FiO2 were significantly lowered,VT and Crs increased significantly,Ppeak,Pplat,and F were improved significantly at 10 min,24 h and 48 h after SI in all cases.No complication occurred.All patients were discharged without adverse event.Conclusions Hypoxemia of ARDS following carcinoma surgery could be improved by lower tidal volume combined with SI.