OBJECTIVE To explore and evaluate the machine learning model for prediction of bacterial bloodstream infections established based on routine test data.METHODS By means of retrospective survey,a total of 5 421 pa-tients who were hospitalized in 3 medical institutions from Jan.2015 to Dec.2022 were recruited as the research subjects,1 914 of whom were assigned as the bloodstream infection group,and 3 507 were assigned as the non-bloodstream infection group.The baseline data including gender and age and the results of routine laboratory tests were collected from the enrolled patients.The 3 types of machine learning algorithms,logistic regression,support vector machine and random forest,were respectively used for the screening of the optimal prediction model;the contribution of feature variables to the predictive capability of the model was interpreted through SHAP.The fea-ture variables of the model were optimized by using recursive feature elimination method,and the predictive effi-ciency of the model was evaluated by the area under the curve(AUC)of receiver operating characteristic(ROC)curves.RESULTS Totally 26 variables involving age,gender and blood routine test indexes were included.The random forest was chosen as the optimal machine learning algorithm for the establishment of prediction model for bloodstream infections,and the accuracy of the model was 0.709,with the AUC 0.706.The result of SHAP ex-planation indicated that the age,hematokrit and erythrocyte volume distribution width-CV had remarkable effect on the model's making right decisions.17 variables of the prediction model showed more remarkable effect than 26 variable on distinguishing from the gram-positive bacteria bloodstream infections from the gram-negative bacteria bloodstream infections,with the AUC 0.715,the sensitivity 0.701,the specificity 0.632.CONCLUSIONS The prediction model that is established based on the blood routine test indexes by machine learning algorithm can pre-dict the bacterial bloodstream infection.Meanwhile,the feature selection strategy can further improve the predic-tive efficiency of the model on basis of lowering the dimensionality.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Objective To develop a hypoxia endurance testing system for aviation physiological training of pilots.Methods The hypoxia endurance testing system comprised a low-oxygen mixed gas generator,a pressurization system for low-oxygen mixed gas and a personal breathing apparatus.The low-oxygen mixed gas generator consisted of a main unit composed of an air compressor,a filter,a buffer tank,polymer membrane,a control module,sensors and regulators,wire cables,supporting hoses,etc.;the pressurization system for low-oxygen mixed gas was made up of a protective box,a cooling fan,a motor and a driver,a control module,a solenoid valve,a convergence block,a pressure gauge,etc.;the personal breating apparatus was composed of a gas cylinder,a pressure reducer,an oxygen supply regulator,etc.Forty-eight subjects were selected for hypoxia exposure tests to verify the effectiveness of the system.Results The system developed had the functions of low-oxygen gas preparation,pressurized filling and hypoxia experiment,and the experimental results indicated the acute hypoxia exposure by the system significantly caused signs and symptoms of hypoxia and weakened physiological functions.Conclusion The system developed gains advantages in high accuracy of gas volume fraction control,safety and remarkable effect of simulated hypoxia,and can be an effective tool for acute high-altitude hypoxia testing and training of pilots.[Chinese Medical Equipment Journal,2025,46(10):23-28]

Objective:To investigate the effect of nursing measures based on the Rockall scoring system combined with the SBAR communication model in patients with acute upper gastrointestinal bleeding.Methods:A convenience sampling method was used to select 140 patients with acute upper gastrointestinal bleeding admitted to the First Affiliated Hospital of Zhengzhou University from June 2022 to January 2024. The patients were divided into a control group and an observation group, with 70 cases in each. The control group received nursing measures based on the Rockall scoring system, while the observation group received nursing measures based on the Rockall scoring system combined with the SBAR communication model. Treatment compliance, bleeding status, length of hospital stay, psychological state, and self-management behavior scores were compared between the two groups.Results:After intervention, the treatment compliance of the observation group was significantly higher than that of the control group ( P<0.05) . The bleeding cessation time and hospital stay time were shorter in the observation group than in the control group ( P<0.05) . Eight weeks after intervention, the scores of Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) in the observation group were lower than those in the control group ( P<0.05) . Six months after intervention, the scores of all dimensions and the total score of self-management behaviors in the observation group were significantly higher than those in the control group ( P<0.05) . Conclusions:Nursing interventions based on the Rockall scoring system combined with the SBAR communication model can improve treatment compliance, reduce negative emotions, and enhance self-management ability in patients with acute upper gastrointestinal bleeding.

Objective:To construct a smart elderly education system that in line with the current situation under the Healthy China strategy and explore the constraints on its institutional implementation,in order to provide a basis for scientifically evaluating the implementation effect of this system.Methods:A questionnaire survey was conducted on 34 experts in related fields.The analytic hierarchy process(AHP)was used to perform quantitative and qualitative analyses on the construction of the smart elderly education system,and the weights of the importance of each scheme were obtained.Results:The constructed model of the smart elderly education system included 5 first-level indicators and 15 second-level indicators.Calculations of the judgment matrix for the 5 first-level indicators showed that the maximum eigenvalue(λmax)=5.071 4,the random consistency index(RI)=1.12,the consistency index(CI)=0.017 8,and the consistency ratio(CR)=0.015 9.With CR＜0.1,the result met the consistency requirement.For the second-level indicators under each first-level indicator,pairwise comparison judgment matrices were constructed.The CR values of all 5 judgment matrices were＜0.1.In summary,all judgment matrices passed the consistency test and were applicable.Among the first-level indicators,the top three by weights were guarantee mechanisms,demand orientation,and implementation effectiveness.Among the second-level indicators,the top three by combined weights were funding support capacity,health literacy improvement rate,and health demand identification mechanism.Conclusions:The indicator evaluation system for the smart elderly education system constructed based on AHP includes core dimensions such as guarantee mechanisms and demand orientation,responding to the key issues of institutional implementation.The selected indicators are both objective and practical,and can serve as reference tools for actual evaluation.

Objective:To analyze the effect of continuous positive airway pressure (CPAP) on maternal and neonatal outcomes in pregnant women with obstructive sleep apnea syndrome (OSAS), especially on the incidence of hypertensive disorder in pregnancy (HDP) in women with moderate to severe OSAS.Methods:A total of 180 pregnant women with OSAS who were diagnosed through sleep monitoring during pregnancy due to high-risk factors of OSAS and registered in Peking University People′s Hospital from January 2021 to May 2024 were selected as the study subjects. Clinical data were collected from medical records for retrospective analysis. According to whether they received standardized treatment with CPAP, they were divided into the CPAP treatment group (42 cases) and the control group (138 cases). The CPAP treatment group consisted of 9 pregnant women with moderate to severe OSAS, while the control group consisted of 34 pregnant women with moderate to severe OSAS. The maternal and neonatal outcomes, the incidence of HDP, placental weight after delivery and placental weight/neonatal birth weight ratio were compared between the two groups.Results:(1) The average gestational age of pregnant women in the CPAP treatment group was higher than that in the control group [(38.7±1.0) vs (38.0±1.4) weeks], the proportion of infants small for gestational age (SGA) in the CPAP treatment group was lower [0 (0/42) vs 12.3% (17/138)], and the birth weight of infants in the CPAP treatment group was bigger [(3 396±475) vs (3 082±710) g); the differences between the two groups were statistically significant (all P<0.05). There were no significant differences between the CPAP treatment group and the control group in terms of delivery mode, rates of postpartum hemorrhage and preterm birth, umbilical artery blood gas analysis pH<7.1, lactate≥6.0 mmol/L, base excess<-12.0 mmol/L and the incidence of gestational diabetes mellitus and HDP (all P>0.05). (2) The placental weight of the CPAP treatment group was significantly lower than that of the control group [(554.0±70.6) vs (615.7±119.1) g], the placental weight/newborn birth weight ratio of the CPAP treatment group was significantly lower than that of the control group (median: 0.17 vs 0.19), and the differences were statistically significant (all P<0.05). (3) The incidence of HDP in pregnant women with moderate to severe OSAS in the CPAP treatment group was lower than that in the control group [1/9 vs 61.8% (21/34)], and the difference was statistically significant ( P<0.05). Conclusions:CPAP treatment could prolong the gestational age in pregnant women with OSAS, reduce the incidence of SGA, increase the birth weight of infants, and reduce the incidence of HDP in pregnant women with moderate to severe OSAS, and is worth promoting in clinical practice. The improvement of neonatal outcomes by CPAP treatment is closely related to the placenta, which is worthy of further exploration.

Objective To develop a hypoxia endurance testing system for aviation physiological training of pilots.Methods The hypoxia endurance testing system comprised a low-oxygen mixed gas generator,a pressurization system for low-oxygen mixed gas and a personal breathing apparatus.The low-oxygen mixed gas generator consisted of a main unit composed of an air compressor,a filter,a buffer tank,polymer membrane,a control module,sensors and regulators,wire cables,supporting hoses,etc.;the pressurization system for low-oxygen mixed gas was made up of a protective box,a cooling fan,a motor and a driver,a control module,a solenoid valve,a convergence block,a pressure gauge,etc.;the personal breating apparatus was composed of a gas cylinder,a pressure reducer,an oxygen supply regulator,etc.Forty-eight subjects were selected for hypoxia exposure tests to verify the effectiveness of the system.Results The system developed had the functions of low-oxygen gas preparation,pressurized filling and hypoxia experiment,and the experimental results indicated the acute hypoxia exposure by the system significantly caused signs and symptoms of hypoxia and weakened physiological functions.Conclusion The system developed gains advantages in high accuracy of gas volume fraction control,safety and remarkable effect of simulated hypoxia,and can be an effective tool for acute high-altitude hypoxia testing and training of pilots.[Chinese Medical Equipment Journal,2025,46(10):23-28]

Objective:To construct a smart elderly education system that in line with the current situation under the Healthy China strategy and explore the constraints on its institutional implementation,in order to provide a basis for scientifically evaluating the implementation effect of this system.Methods:A questionnaire survey was conducted on 34 experts in related fields.The analytic hierarchy process(AHP)was used to perform quantitative and qualitative analyses on the construction of the smart elderly education system,and the weights of the importance of each scheme were obtained.Results:The constructed model of the smart elderly education system included 5 first-level indicators and 15 second-level indicators.Calculations of the judgment matrix for the 5 first-level indicators showed that the maximum eigenvalue(λmax)=5.071 4,the random consistency index(RI)=1.12,the consistency index(CI)=0.017 8,and the consistency ratio(CR)=0.015 9.With CR＜0.1,the result met the consistency requirement.For the second-level indicators under each first-level indicator,pairwise comparison judgment matrices were constructed.The CR values of all 5 judgment matrices were＜0.1.In summary,all judgment matrices passed the consistency test and were applicable.Among the first-level indicators,the top three by weights were guarantee mechanisms,demand orientation,and implementation effectiveness.Among the second-level indicators,the top three by combined weights were funding support capacity,health literacy improvement rate,and health demand identification mechanism.Conclusions:The indicator evaluation system for the smart elderly education system constructed based on AHP includes core dimensions such as guarantee mechanisms and demand orientation,responding to the key issues of institutional implementation.The selected indicators are both objective and practical,and can serve as reference tools for actual evaluation.

OBJECTIVE To explore and evaluate the machine learning model for prediction of bacterial bloodstream infections established based on routine test data.METHODS By means of retrospective survey,a total of 5 421 pa-tients who were hospitalized in 3 medical institutions from Jan.2015 to Dec.2022 were recruited as the research subjects,1 914 of whom were assigned as the bloodstream infection group,and 3 507 were assigned as the non-bloodstream infection group.The baseline data including gender and age and the results of routine laboratory tests were collected from the enrolled patients.The 3 types of machine learning algorithms,logistic regression,support vector machine and random forest,were respectively used for the screening of the optimal prediction model;the contribution of feature variables to the predictive capability of the model was interpreted through SHAP.The fea-ture variables of the model were optimized by using recursive feature elimination method,and the predictive effi-ciency of the model was evaluated by the area under the curve(AUC)of receiver operating characteristic(ROC)curves.RESULTS Totally 26 variables involving age,gender and blood routine test indexes were included.The random forest was chosen as the optimal machine learning algorithm for the establishment of prediction model for bloodstream infections,and the accuracy of the model was 0.709,with the AUC 0.706.The result of SHAP ex-planation indicated that the age,hematokrit and erythrocyte volume distribution width-CV had remarkable effect on the model's making right decisions.17 variables of the prediction model showed more remarkable effect than 26 variable on distinguishing from the gram-positive bacteria bloodstream infections from the gram-negative bacteria bloodstream infections,with the AUC 0.715,the sensitivity 0.701,the specificity 0.632.CONCLUSIONS The prediction model that is established based on the blood routine test indexes by machine learning algorithm can pre-dict the bacterial bloodstream infection.Meanwhile,the feature selection strategy can further improve the predic-tive efficiency of the model on basis of lowering the dimensionality.

Tuberculosis is a serious public health problem worldwide,including China.It is a typical zoonotic disease that can be transmitted between people and animals.Effective control of zoonotic tuberculosis(ZTB)is important for achieving the END-TB goal on schedule,and markedly influences the national economy.This article reviews the pathogenic characteristics,epidemic status,history,and progress in construction of a system for global and domestic ZTB prevention and control strategies.Our goal is to help achieve complete control and eradication of ZTB and tuberculosis through departmental cooperation,and joint prevention and control measures,by improving systematic understanding of ZTB among personnel formulating ZTB prevention and control policies,high-risk professionals,and clinical workers.