OBJECTIVE To investigate the suspected outbreak of one incident of carbapenem-resistant Acinetobacter baumannii(CRAB)infection in an intensive care unit(ICU)so as to provide experience and reference for preven-tion and control of multidrug-resistant organisms(MDROs)infections in a grass-root hospital.METHODS The epidemiological survey and environmental hygiene surveillance were performed for 8 patients with CRAB infection who were detected in ICU of Qingbaijiang District People's Hospital from Jul.21,2022 to Aug.6,2022 so as to find out the infection sources and transmission routes and take targeted intervention measures.RESULTS Totally 8 patients had CRAB infection in the ICU in a short time period,the drug resistance spectrum was basically the same;the CRAB infection/colonization rate was 12.50％(8/64),the incidence rate of CRAB infection was 7.81％(5/64),which was higher during this period than that during the same period in 2020 and 2021(P＜0.05).The environmental hygiene surveillance showed that the isolation rate of CRAB was 6.00％(3/50).The strains isolated from the hand washing sink between bed 2 and bed 3,the hanging tower of bed 13 and the countertops of treat-ment rooms showed the basically same result of drug susceptibility testing with CRAB strains isolated from the patients.This incident had been effectively under control through targeted prevention and control strategies such as the control and separation of the patients,subgrouping treatment and nursing,repeated deep cleaning and disinfec-tion as well as strict implementation of hand hygiene.CONCLUSION The overloaded enrollment of patients,insuf-ficient between-bed interval,poor and delayed cleaning and disinfection of environmental object surfaces,extensive contamination of instrument and facilities,spare supplies and hand washing sink are probably the leading causes of outbreak and prevalence of CRAB.

Objective To compare the dosimetric differences between volumetric modulated arc therapy(VMAT)and intensity modulated radiation therapy(IMRT)in the irradiation of chest wall and upper and lower clavicle regions after radical mastectomy for breast cancer.Methods A total of 100 patients who were scheduled to receive radiotherapy after radical mastectomy were included and selected as research subjects.Patients were divided into the VMAT group and the IMRT group by random number table method,with 50 cases in each group.The target dose parameters,exposure dose of organs at risk,monitor unit(MU)and treatment time were compared between the two groups.Results There were no statistical differences in V95 and V110 between the VMAT group and the IMRT group(P＞0.05).The D2%in the VMAT group was lower than that of the IMRT group,while D98%and D50%were higher in the VMAT group than those in the IMRT group(P＜0.05).Target area uniformity and target area conformity were better in the VMAT group than those in the IMRT group(P＜0.05).There were no significant differences in mean cardiac dose(Dmean)and ipsilateral lung V5 and V10 between the VMAT group and the IMRT group(P＞0.05).The heart V20 and V30,contralateral lung Dmean,maximum spinal cord dose(Dmax),contralateral breast Dmean,ipsilateral lung Dmean,V20,V30 and mean MU were lower in the VMAT group than those in the IMRT group,and the treatment time was shorter than that in the IMRT group(P＜0.05).Conclusion In the irradiation treatment of chest wall and upper and lower clavicle regions after radical mastectomy,VMAT demonstrates superior dosimetric characteristics and higher treatment efficiency compared with IMRT,particularly in terms of target area uniformity,target area conformity and exposure doses to organs at risk.

Objective To explore different construction models and experiences of clinical laboratory centers under exist-ing Integrated county healthservices entity,analyze and discuss the characteristics of various construction models,and provide ref-erences for the development of county-level clinical laboratory centers.Methods Based on the five factors of"man,machine,material,method,and environment"in Total Quality Management theory,an interview outline and questionnaire were designed for county-level clinical laboratory centers.Eleven county-level clinical laboratory centers across the country were investigated to analyze their construction models,investment returns,and other aspects.Literature reviews and case studies were also conducted to summarize the construction models and characteristics of county-level clinical laboratory centers.Results The construction models of county-level clinical laboratory centers are mainly divided into five types,each with distinct features.Through an analy-sis of the investment returns of these models unde rIntegrated county healthservices entity,it was found that a profit distribution ratio of approximately 5∶5 between county-level clinical laboratory centers and township health centers for referred samples is more conducive to maintaining the stability of sample sources.The construction model of county-level clinical laboratory centers is closely related to the medical service capacity of both county and township levels.Conclusion Counties with stronger county hospital capabilities tend to establish relatively independent regional laboratory centers based on the county hospital's laboratory department.Regardless of the model,the primary goal of county-level clinical laboratory centers should be to provide high-quality testing services coverage across the entire county.The key to the success of county-level clinical laboratory centers lies in motiva-ting grassroots personnel.

Objective:To describe the application methods, types, and effects of wearable devices in sarcopenia.Methods:Following the guidelines for scoping reviews, a systematic search was conducted in PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang Data, and VIP for literature related to wearable device applications in sarcopenia. The search period covered publications from database inception to August 1, 2024.Results:A total of 12 studies were included. Wearable devices in sarcopenia were primarily used for monitoring gait speed, surface electromyography, sleep duration, activity time, and supporting exercise interventions. Common types of wearable devices included activity trackers, smart belts, and smart wristbands. Their effectiveness, feasibility, and role in ensuring activity safety have been preliminarily demonstrated.Conclusions:The application of wearable devices in sarcopenia is still in its early stages but shows great potential. Currently, wearable devices are mainly used to monitor one or a few individual indicators. Future research should focus on developing multi-parameter monitoring devices and conducting large-scale, high-quality trials to validate their effectiveness in both monitoring and supporting exercise interventions. This will help promote their broader application and assist healthcare professionals in the early identification, diagnosis, prevention, and treatment of sarcopenia.

OBJECTIVE To investigate the suspected outbreak of one incident of carbapenem-resistant Acinetobacter baumannii(CRAB)infection in an intensive care unit(ICU)so as to provide experience and reference for preven-tion and control of multidrug-resistant organisms(MDROs)infections in a grass-root hospital.METHODS The epidemiological survey and environmental hygiene surveillance were performed for 8 patients with CRAB infection who were detected in ICU of Qingbaijiang District People's Hospital from Jul.21,2022 to Aug.6,2022 so as to find out the infection sources and transmission routes and take targeted intervention measures.RESULTS Totally 8 patients had CRAB infection in the ICU in a short time period,the drug resistance spectrum was basically the same;the CRAB infection/colonization rate was 12.50％(8/64),the incidence rate of CRAB infection was 7.81％(5/64),which was higher during this period than that during the same period in 2020 and 2021(P＜0.05).The environmental hygiene surveillance showed that the isolation rate of CRAB was 6.00％(3/50).The strains isolated from the hand washing sink between bed 2 and bed 3,the hanging tower of bed 13 and the countertops of treat-ment rooms showed the basically same result of drug susceptibility testing with CRAB strains isolated from the patients.This incident had been effectively under control through targeted prevention and control strategies such as the control and separation of the patients,subgrouping treatment and nursing,repeated deep cleaning and disinfec-tion as well as strict implementation of hand hygiene.CONCLUSION The overloaded enrollment of patients,insuf-ficient between-bed interval,poor and delayed cleaning and disinfection of environmental object surfaces,extensive contamination of instrument and facilities,spare supplies and hand washing sink are probably the leading causes of outbreak and prevalence of CRAB.

Objective To explore different construction models and experiences of clinical laboratory centers under exist-ing Integrated county healthservices entity,analyze and discuss the characteristics of various construction models,and provide ref-erences for the development of county-level clinical laboratory centers.Methods Based on the five factors of"man,machine,material,method,and environment"in Total Quality Management theory,an interview outline and questionnaire were designed for county-level clinical laboratory centers.Eleven county-level clinical laboratory centers across the country were investigated to analyze their construction models,investment returns,and other aspects.Literature reviews and case studies were also conducted to summarize the construction models and characteristics of county-level clinical laboratory centers.Results The construction models of county-level clinical laboratory centers are mainly divided into five types,each with distinct features.Through an analy-sis of the investment returns of these models unde rIntegrated county healthservices entity,it was found that a profit distribution ratio of approximately 5∶5 between county-level clinical laboratory centers and township health centers for referred samples is more conducive to maintaining the stability of sample sources.The construction model of county-level clinical laboratory centers is closely related to the medical service capacity of both county and township levels.Conclusion Counties with stronger county hospital capabilities tend to establish relatively independent regional laboratory centers based on the county hospital's laboratory department.Regardless of the model,the primary goal of county-level clinical laboratory centers should be to provide high-quality testing services coverage across the entire county.The key to the success of county-level clinical laboratory centers lies in motiva-ting grassroots personnel.

Objective To investigate the preventive efficacy of recombinant human granulocyte-macrophage colony-stimulating factor(rhGM-CSF)combined with Kangfuxin liquid on radiation dermatitis in breast cancer patients underwent radiotherapy.Methods A total of 90 breast cancer patients were randomized into the control group(45 cases,rhGM-CSF alone)and the observation group(45 cases,rhGM-CSF+Kangfuxin liquid).Both groups received radiotherapy.The incidence of radiation dermatitis,the time of first occurrence,the healing time and severity of radiation dermatitis(graded by RTOG criteria)were compared between the two groups.Skin growth factors[epidermal growth factor(EGF),basic fibroblast growth factor(bFGF),transforming growth factor-β(TGF-β)]were measured via enzyme linked immunosorbent assay(ELISA)before radiotherapy and 2 weeks after radiotherapy.The quality of life of patients was assessed using the EORTC QLQ-C30 V3.0 questionnaire.Results The incidence of radiation dermatitis was significantly lower in the observation group(35.56%,16/45)than that in the control group(68.89%,31/45,P＜0.05),and the first occurrence time of dermatitis was later,the healing time was shorter,and the severity grade of dermatitis was lower(P＜0.05).Two weeks after radiotherapy,levels of EGF,bFGF,TGF-β and the scores of QLQ-C30 increased in both groups,and those of the observation group were significantly higher than the control group(P＜0.05).Conclusion Combining rhGM-CSF with Kangfuxin liquid can effectively prevent radiation dermatitis in breast cancer patients by reducing incidence and severity,delaying onset time,accelerating healing,and improving quality of life.

Objective To compare the dosimetric differences between volumetric modulated arc therapy(VMAT)and intensity modulated radiation therapy(IMRT)in the irradiation of chest wall and upper and lower clavicle regions after radical mastectomy for breast cancer.Methods A total of 100 patients who were scheduled to receive radiotherapy after radical mastectomy were included and selected as research subjects.Patients were divided into the VMAT group and the IMRT group by random number table method,with 50 cases in each group.The target dose parameters,exposure dose of organs at risk,monitor unit(MU)and treatment time were compared between the two groups.Results There were no statistical differences in V95 and V110 between the VMAT group and the IMRT group(P＞0.05).The D2%in the VMAT group was lower than that of the IMRT group,while D98%and D50%were higher in the VMAT group than those in the IMRT group(P＜0.05).Target area uniformity and target area conformity were better in the VMAT group than those in the IMRT group(P＜0.05).There were no significant differences in mean cardiac dose(Dmean)and ipsilateral lung V5 and V10 between the VMAT group and the IMRT group(P＞0.05).The heart V20 and V30,contralateral lung Dmean,maximum spinal cord dose(Dmax),contralateral breast Dmean,ipsilateral lung Dmean,V20,V30 and mean MU were lower in the VMAT group than those in the IMRT group,and the treatment time was shorter than that in the IMRT group(P＜0.05).Conclusion In the irradiation treatment of chest wall and upper and lower clavicle regions after radical mastectomy,VMAT demonstrates superior dosimetric characteristics and higher treatment efficiency compared with IMRT,particularly in terms of target area uniformity,target area conformity and exposure doses to organs at risk.

Objective To investigate the preventive efficacy of recombinant human granulocyte-macrophage colony-stimulating factor(rhGM-CSF)combined with Kangfuxin liquid on radiation dermatitis in breast cancer patients underwent radiotherapy.Methods A total of 90 breast cancer patients were randomized into the control group(45 cases,rhGM-CSF alone)and the observation group(45 cases,rhGM-CSF+Kangfuxin liquid).Both groups received radiotherapy.The incidence of radiation dermatitis,the time of first occurrence,the healing time and severity of radiation dermatitis(graded by RTOG criteria)were compared between the two groups.Skin growth factors[epidermal growth factor(EGF),basic fibroblast growth factor(bFGF),transforming growth factor-β(TGF-β)]were measured via enzyme linked immunosorbent assay(ELISA)before radiotherapy and 2 weeks after radiotherapy.The quality of life of patients was assessed using the EORTC QLQ-C30 V3.0 questionnaire.Results The incidence of radiation dermatitis was significantly lower in the observation group(35.56%,16/45)than that in the control group(68.89%,31/45,P＜0.05),and the first occurrence time of dermatitis was later,the healing time was shorter,and the severity grade of dermatitis was lower(P＜0.05).Two weeks after radiotherapy,levels of EGF,bFGF,TGF-β and the scores of QLQ-C30 increased in both groups,and those of the observation group were significantly higher than the control group(P＜0.05).Conclusion Combining rhGM-CSF with Kangfuxin liquid can effectively prevent radiation dermatitis in breast cancer patients by reducing incidence and severity,delaying onset time,accelerating healing,and improving quality of life.