Objective To investigate and analyze the current situation of the construction of Smart Hospital in the dis-trict-level hospital of Beijing,and to provide reference for thedistrict-level hospitals to promote the construction of Smart Hospitals.Methods A questionnaire survey was conducted in Beijing district-level hospitals,and the construc-tion of Smart Hospital was analyzed by descriptive statistical analysis.Results The overall construction rate of Beijing district-level hospitals smart service business function was 50.98％,and the overall average construction rate of hos-pital smart management business function was 46.72％.93.75％hospitals thought that the investment in Smart Hos-pital construction was insufficient.The functions of smart service and management in different grades and categories of hospitals were different.Conclusion In order to promote the construction of Smart Hospital in Beijingdistrict-level hospitals,we should improve the top-level system such as strategic planning for the construction of smart hospi-tals,increase the investment in hospital informatization and talent teams,strengthen the standardization of intercon-nection between different hospitals,enhance the sharing and utilization of medical data and information,and strengthen the application of new hospital technologies and hospital information security.

Objective To investigate and analyze the current situation of the construction of Smart Hospital in the dis-trict-level hospital of Beijing,and to provide reference for thedistrict-level hospitals to promote the construction of Smart Hospitals.Methods A questionnaire survey was conducted in Beijing district-level hospitals,and the construc-tion of Smart Hospital was analyzed by descriptive statistical analysis.Results The overall construction rate of Beijing district-level hospitals smart service business function was 50.98％,and the overall average construction rate of hos-pital smart management business function was 46.72％.93.75％hospitals thought that the investment in Smart Hos-pital construction was insufficient.The functions of smart service and management in different grades and categories of hospitals were different.Conclusion In order to promote the construction of Smart Hospital in Beijingdistrict-level hospitals,we should improve the top-level system such as strategic planning for the construction of smart hospi-tals,increase the investment in hospital informatization and talent teams,strengthen the standardization of intercon-nection between different hospitals,enhance the sharing and utilization of medical data and information,and strengthen the application of new hospital technologies and hospital information security.

OBJECTIVE To investigate the impact of dapagliflozin on contrast-induced acute kidney injury(CIAKI)and prognosis in patients with diabetes mellitus type 2(T2DM)and acute coronary syndrome(ACS)who underwent percutaneous coronary intervention(PCI).METHODS Retrospective selection of data on T2DM patients with ACS who underwent PCI treatment in the Cardiology Department of Tianjin Chest Hospital from January 1st 2021 to December 31st 2022.The patients were divided into dapagliflozin group(96 cases)and control group(148 cases)based on whether they received dapagliflozin or not.Renal function indicators were measured for all enrolled patients before PCI and at 48 h and 1 week after PCI,including blood urea nitrogen(BUN),serum creatinine(Scr),estimated glomerular filtration rate(eGFR),cystatin-C(Cys-C),kidney injury molecule-1(KIM-1)and β2-microglobulin(β2-MG).All patients were followed up for at least 1 year.The incidence of CIAKI and major adverse cardiac event(MACE)during follow-up were recorded for both groups.Logistic regression was used to analyze the impact of dapagliflozin on the occurrence of CIAKI,while the Log-rank test was applied to compare the incidence of MACE between the two groups.Cox regression was employed to analyze the impact of dapagliflozin on prognosis.RESULTS At 48 h and 1 week after PCI,serum levels of Cys-C,KIM-1 and β2-MG were significantly lower in the dapagliflozin group compared to the control group(P＜0.05).The incidence of CIAKI was lower in the dapagliflozin group compared to the control group(6.25%vs.14.86%,P=0.042).Logistic regression analysis revealed that dapagliflozin was an independent protective factor against CIAKI(OR=0.280,95%CI 0.101-0.780,P=0.015).During the follow-up period,the incidence of MACE was lower in the dapagliflozin group compared to the control group(7.29%vs.17.57%,P=0.049).Cox regression analysis indicated that dapagliflozin reduced the occurrence of MACE after PCI(HR=0.374,95%CI 0.161-0.866,P=0.022).CONCLUSIONS With adequate hydration,the use of dapagliflozin does not increase the risk of CIAKI following PCI in T2DM patients with ACS.

[Objective]To investigate primary and secondary transfer of exfoliated cells from human hands on non-porous substrates such as plastic steering wheel or computer mouse.[Methods]DNA detection sensitivity and detection limit for mixed DNA profiling were examined to understand our laboratory's ability to test for trace DNA.Forensic swabs were used to collect samples from volunteers'one-hour-long unwashed hands,substrates touched by volunteers'immediately or 30 min following shaking hands,and individual A's daily-use substrates touched by individual B and then by individual A again.Simulations were conducted to assess the potential for introduction of another person's exfoliated cells from hands into routine casework samples.[Results]Our laboratory can obtain a full DNA profile from as little as 0.020 ng of DNA and detect minor components in a 1:9 mixed DNA sample.85%of samples from unwashed hands yielded a full DNA profile.Primary transfer of a full DNA profile was found in 77%of substrates touched by volunteers'dominant hand 30 min after hand washing,allowing differentiation between good and poor shedders,with no significant difference in genders and substrate types.75%of substrates touched 30 min after hand washing and then immediately following handshaking yielded the other individual's DNA profile(secondary transfer),with the number of short tandem repeat(STR)loci detected ranging from 0 to 23;the percentage and number decreased substantially when the substrates were touched 30 minutes later.No foreign DNA was detected in routine casework samples with introduced exfoliated cells from hands.When two individuals took turns touching items with their hands,the major contributor to the DNA profile was not always the individual who made the last contact.[Conclusions]Primary and secondary DNA transfer can be detected on non-porous substrates,and based on the deposit of hand exfoliated cells,individuals can be categorized as good or poor shedders,which is an important factor affecting detection of DNA transfer.Besides considering the laboratory's DNA detection sensitivity,if DNA is detected on substrates by hand contact,we need to take into account the potential for secondary transfer at different levels of activity when interpreting the results.

The DNA of the two samples was amplified by PCR using the GSTARTM 30X and AGCU X19 commercial kits,respectively,and it was found that the genotyping of the two kits was different at the DXS10103 locus,with a difference of 2 base pairs.After analyzing the sequence information of DXS10103 locus,it was found that there is a repeat sequence of[CA]from base 48 to base 29 at the 5′ end upstream of the core repeat sequence.After high-throughput sequencing detection,2-base[CA]insertion was found in the repetitive structure of the flanking sequence.The positioning of the forward primer in the GSTARTM 30X kit was strategically located near the core sequences,effectively preventing any interference from the[CA]repeated sequence in the surrounding sequence.In contrast,the AGCU X19 kit amplification region included a repeat structure of the[CA]dinucleotide,a 2-base insertion was detected in the two samples,and stutters due to the repeat structure of the flanking sequence were detected.A similar situation also exists for the D21S1270 locus.Based on the findings in this study,when designing primers for the locus,it is recommended to avoid repetitive sequences in the flanking regions to prevent the occurrence of mutations in the flanking sequences and the resulting effects of stutter.

The DNA of the two samples was amplified by PCR using the GSTARTM 30X and AGCU X19 commercial kits,respectively,and it was found that the genotyping of the two kits was different at the DXS10103 locus,with a difference of 2 base pairs.After analyzing the sequence information of DXS10103 locus,it was found that there is a repeat sequence of[CA]from base 48 to base 29 at the 5′ end upstream of the core repeat sequence.After high-throughput sequencing detection,2-base[CA]insertion was found in the repetitive structure of the flanking sequence.The positioning of the forward primer in the GSTARTM 30X kit was strategically located near the core sequences,effectively preventing any interference from the[CA]repeated sequence in the surrounding sequence.In contrast,the AGCU X19 kit amplification region included a repeat structure of the[CA]dinucleotide,a 2-base insertion was detected in the two samples,and stutters due to the repeat structure of the flanking sequence were detected.A similar situation also exists for the D21S1270 locus.Based on the findings in this study,when designing primers for the locus,it is recommended to avoid repetitive sequences in the flanking regions to prevent the occurrence of mutations in the flanking sequences and the resulting effects of stutter.

Objective:To study the application of three-dimensional(3D) printed individualized tray in impression taken of presurgical nasoalveolar molding(PNAM) for newborn with cleft and palate.Methods:The newborns with unilateral/bilateral cleft lip and palate treated with PNAM during 2015 to 2020 in School and Hospital of Stomatology, China Medical University, were chosen. Their clinical materials were retrospectively analyzed. Maxillary impressions taken by 3D printed individualized trays were compared with those taken by modified traditional tray. The indexes were evaluated including the numbers of defects (bubbles with diameter>1 mm and exposure of tray) in each impression; the impression quality grade (perfect 1, good 2, qualified 3 and unqualified 4), and the integrity and legibility of impressions [evaluated by 3 orthodontists using visual analog scale(VAS)]. The date was analyzed by SPSS 23.0. Rank-sum test was used for comparison between groups.Results:A total of 22 patients were included. There were 7 patients (3 males, 4 females, 3-28 days old) in modified traditional tray group and 15 patients (10 males, 5 females, 4-26 days old) in 3D printed individualized trays group. All patients finished the PNAM treatment before repairment of cleft lip. The average treatment duration were 136 days with 131 days in modified traditional tray group and 137 days in 3D printed individualized trays group. (1) The impressions made by conventional method had more defects [6(5, 7)] than those made by 3D printed individualized trays[2(1, 2)]( P<0.05). (2)The impression taken by modified traditional tray was mainly qualified[3(2, 3)scores] and that taken by 3D printed individualized tray exhibited higher grade [good, 2(2, 2) scores]( P<0.01). (3) Compared with modified traditional tray group, the scores of VAS on integrity of impression taken by 3D printed individualized tray were significantly high( P<0.05). Itemized evaluation showed that the integrity scores on all positions except vestibular sulcus had significant difference between groups( P<0.05 or P<0.01). The scores of VAS on legibility of impression taken by 3D printed individualized tray were significantly higher than those taken by modified traditional tray( P<0.05). As for itemized evaluation, legibility scores on all positions except upper frenum had significant difference between groups( P<0.05 or P<0.01). Conclusions:The impression taken by 3D printing individualized tray has higher quality, integrity and legibility.

Objective:To study the application of three-dimensional(3D) printed individualized tray in impression taken of presurgical nasoalveolar molding(PNAM) for newborn with cleft and palate.Methods:The newborns with unilateral/bilateral cleft lip and palate treated with PNAM during 2015 to 2020 in School and Hospital of Stomatology, China Medical University, were chosen. Their clinical materials were retrospectively analyzed. Maxillary impressions taken by 3D printed individualized trays were compared with those taken by modified traditional tray. The indexes were evaluated including the numbers of defects (bubbles with diameter>1 mm and exposure of tray) in each impression; the impression quality grade (perfect 1, good 2, qualified 3 and unqualified 4), and the integrity and legibility of impressions [evaluated by 3 orthodontists using visual analog scale(VAS)]. The date was analyzed by SPSS 23.0. Rank-sum test was used for comparison between groups.Results:A total of 22 patients were included. There were 7 patients (3 males, 4 females, 3-28 days old) in modified traditional tray group and 15 patients (10 males, 5 females, 4-26 days old) in 3D printed individualized trays group. All patients finished the PNAM treatment before repairment of cleft lip. The average treatment duration were 136 days with 131 days in modified traditional tray group and 137 days in 3D printed individualized trays group. (1) The impressions made by conventional method had more defects [6(5, 7)] than those made by 3D printed individualized trays[2(1, 2)]( P<0.05). (2)The impression taken by modified traditional tray was mainly qualified[3(2, 3)scores] and that taken by 3D printed individualized tray exhibited higher grade [good, 2(2, 2) scores]( P<0.01). (3) Compared with modified traditional tray group, the scores of VAS on integrity of impression taken by 3D printed individualized tray were significantly high( P<0.05). Itemized evaluation showed that the integrity scores on all positions except vestibular sulcus had significant difference between groups( P<0.05 or P<0.01). The scores of VAS on legibility of impression taken by 3D printed individualized tray were significantly higher than those taken by modified traditional tray( P<0.05). As for itemized evaluation, legibility scores on all positions except upper frenum had significant difference between groups( P<0.05 or P<0.01). Conclusions:The impression taken by 3D printing individualized tray has higher quality, integrity and legibility.

Objective:To analyze the incidence and epidemiological characteristics of traumatic spinal cord injury in China in 2018.Methods:Multi-stage stratified cluster sampling was used to randomly select hospitals capable of treating patients with spinal cord injury from 3 regions，9 provinces and 27 cities in China to retrospectively investigate eligible patients with traumatic spinal cord injury admitted in 2018. National and regional incidence rates were calculated. The data of cause of injury，injury level，severity of injury，segment and type of fracture，complications，death and other data were collected by medical record questionnaire，and analyzed according to geographical region，age and gender.Results:Medical records of 4，134 patients were included in this study，with a male-to-female ratio of 2.99∶1. The incidence of traumatic spinal cord injury in China in 2018 was 50.484 / 1 million （95% CI 50.122-50.846）. The highest incidence in the Eastern region was 53.791 / 1 million （95% CI 53.217-54.365）. In the whole country，the main causes of injury were high falls （29.58%），as well as in the Western region （40.68%），while the main causes of injury in the Eastern and Central regions were traffic injuries （31.22%，30.10%）. The main injury level was cervical spinal cord in the whole country （64.49%），and the proportion of cervical spinal cord injury in the Central region was the highest （74.68%），and the proportion of lumbosacral spinal cord injury in the Western region was the highest （32.30%）. The highest proportion of degree of injury was incomplete quadriplegia （55.20%），and the distribution pattern was the same in each region. A total of 65.87% of the patients were complicated with fracture or dislocation，77.95% in the Western region and only 54.77% in the Central region. In the whole country，the head was the main combined injury （37.87%），as well as in the Eastern and Central regions，while the proportion of chest combined injury in the Western region was the highest （38.57%）. A total of 32.90% of the patients were complicated with respiratory complications. There were 23 patients （0.56%） died in hospital，of which 17（73.91%） died of respiratory dysfunction. Conclusions:The Eastern region of China has a high incidence of traumatic spinal cord injury. Other epidemiological features include high fall as the main cause of injury cervical spinal cord injury as the main injury level，incomplete quadriplegia as the main degree of injury，head as the main combined injury，and respiratory complications as the main complication.

Objective To explore preoperative psychological experience in patients with the tibia and fibula fracture that treated with 3D printing individualized external fixation, and provide theoretical basis for the medical treatment and care. Methods From December 2013 to November 2015, sevenpatentstreated with 3D printing individualized external fixation in Xi′an Honghui Hospital, Xi′an Jiaotong University Health Science Center were selected as the interview object. This qualitative study was completed by phenomenon research methods, and combined with a variety of forms of interview.Colaizzi content analysis method was used to analyze the contents of collected data, and sort and refine the theme. Results Four effective subjects were extracted about preoperative psychological experience in patients with the tibia and fibula fracture treated with 3D printing individualized external fixation, in turn were uncertainty effect of surgery; high expectations, but the lack of knowledge about 3D printing, economic burden of disease; longing for family support system. Conclusions Medical staff should pay attention to preoperative psychological feelings in patients with the tibia and fibula fracture treated with 3D printing individualized external fixation, deal with a targeted psychological nursing and coping style, provide an effective nursing intervention and health education. further more optimize the 3D external fixation cost,and incorporate the 3D external fixation into the social medical insurance category.