Objective To analyze the genomic characteristics of Legionella pneumophila (L. pneumophila) isolated from industrial circulating cooling water in workplace. Methods A total of 20 L. pneumophila strains isolated from industrial circulating cooling water collected from eight chemical enterprises were selected as the research subjects. Whole-genome sequencing was performed on the strains, followed by multilocus sequence typing (MLST), whole-genome single nucleotide polymorphism analysis, virulence factor profiling, and antibiotic resistance gene detection. Results The dominant MLST typing among the 20 L. pneumophila strains was ST2. Serogroup 1 (Lp1) strains exhibited high genetic diversity. Strains from different enterprises showed substantial genomic diversity, suggesting possible inter-enterprise dissemination. Each isolate harbored 175-295 virulence genes; among them, virulence genes were identified, and 139 genes were detected in all the 20 strains. These genes primarily included those related to the Dot/Icm type Ⅳ bacterial secretion system, flagellar synthesis and motility, and type Ⅳ pili. The number of virulence genes carried by L. pneumophila strains of different ST types differed (P<0.01), with unidentified sequence types harboring more virulence genes than other STs (P<0.01). A total of four resistance genes were predicted, including aminoglycoside phosphotransferase-encoding gene APH(9)-Ia, carbapenemase-encoding gene OXA-29, and efflux pump genes-encoding genes LpeA and LpeB, with detection rates of 100.00%, 100.00%, 10.00%, and 10.00%, respectively. These genes may confer resistance to cephalosporins, penicillins, and aminoglycosides, and all strains were multidrug resistance. Conclusion L. pneumophila isolated from industrial recirculating cooling water exhibits high genetic diversity, strong pathogenicity, and significant multidrug resistance potential.

Objective To investigate the perioperative use of antimicrobial agents in class Ⅰ incisional ophthalmic surgeries in secondary first-class and above medical institutions in Shanghai City,and provide a basis for the rational use of antimicrobial agents in such surgeries.Methods Perioperative antimicrobial prophylaxis(PAP)in patients undergoing class Ⅰ incisional ophthalmic surgery reported by secondary first-class and above hospitals in Shanghai City from 2017 to 2022 was collected retrospectively.The prophylactic use rate,types,rationality of selection,and timing of use of antimicrobial agents were analyzed comprehensively.Results From 2017 to 2022,a total of 54 868 cases of class Ⅰ incisional ophthalmic surgeries were reported from secondary first-class and above hospitals in Shanghai City.The PAP rates in tertiary comprehensive hospitals,tertiary specialty hospitals,tertiary traditional Chinese medicine hospitals,and secondary comprehensive hospitals were 4.72％,1.79％,3.22％,and 6.63％,re-spectively.The overall PAP rate showed a yearly decreasing trend,from 6.39％in 2017 to 2.31％in 2021.Among different types of hospitals,the PAP rate in secondary comprehensive hospitals decreased most significantly,from 12.72％in 2017 to 0.53％in 2022.The main types of prophylactic antimicrobial use were first-,second-and third-generation cephalosporins,and quinolones.The rational selection rates of antimicrobial agents were highest in ter-tiary comprehensive hospitals(17.13％)and lowest in tertiary specialty hospitals(1.08％).The PAP rates in sys-temic veins 0.5-1 hour before surgery were highest in tertiary specialty hospitals(88.17％)and lowest in tertiary comprehensive hospitals(71.53％).The withdrawal rates of antimicrobial agents within 24 hours after surgery were highest in tertiary traditional Chinese medicine hospitals(80.87％)and lowest in tertiary specialty hospitals(13.26％).Conclusion The PAP for class Ⅰ incisional ophthalmic surgeries in secondary first-class and above medical institutions in Shanghai City still presents certain irrational phenomena in terms of antimicrobial types and administration routes.The administration rate 0.5-1 hour before surgery and withdrawal rate of antimicrobial agents within 24 hours after surgery need to be further improved.Enhanced management is necessary to promote more rational use of antimicrobial agents.

Medical ultrasound technology is widely used for diagnosis and therapy in clinical practice.Ultrasound probes,which are directly contact with patients,pose a potential risk of pathogen transmission.This expert consen-sus was developed by a multidisciplinary team based on international guidelines,standards in China,and the results of a national survey,aiming to reduce the risk of healthcare-associated infection through standardizing reprocessing of medical ultrasound probes,and formulating consensus recommendations with the Delphi method.The consensus clarifies the reprocessing principles for three types of ultrasound probes of different infection risks:external-use ul-trasound probes,interventional percutaneous ultrasound probes,and internal-use ultrasound probes,puts forward systematic suggestions on the reprocessing standards and disinfection levels of ultrasound probe isolation covers and coupling agents,the reprocessing procedures and methods of ultrasound probes,as well as architectural layout and management of reprocessing,so as to provide a scientific prevention and control framework for ensuring ultrasound diagnosis and therapy safety.

Objective:To investigate the clinical effect of the third diverter device in the treatment of intracranial aneurysms.Methods:This is a retrospective case series study. A retrospective study was conducted on patients with intracranial aneurysms treated with the new flow-diverting device at the Department of Neurosurgery, Peking University Third Hospital from March 2023 to February 2024. There were 11 males and 27 females, aged (58.6±12.9) years (range: 27 to 82 years). All patients underwent digital subtraction angiography(DSA) at the time of surgery to observe the stent position, wall apposition. The degree of aneurysm embolization was evaluated using the O′Kelly-Marotta (OKM) grading system,with OKM grade D as complete occlusion. The incidence of perioperative intracranial hemorrhagic and ischemic complications was recorded. The modified Rankin scale (mRS) was used to assess patients′ neurological function at discharge. CT angiography and DSA were performed 6 to 12 months postoperatively to evaluate the stent position and aneurysm embolization.Results:A total of 38 patients with 39 intracranial aneurysms were treated using 40 stents, with coil embolization applied to 6 aneurysms. No ischemic or hemorrhagic events occurred during the perioperative period. At discharge, all patients had an mRS score of 0. During follow-up, one patient with an ophthalmic artery segment aneurysm experienced transient monocular blindness. Imaging follow-up by DSA showed that the complete aneurysm occlusion rate was 89.7%(35/39) at 6 months and 96.8%(30/31) at 12 months.Conclusion:The flow-diverting device demonstrates a low complication rate and a high aneurysm occlusion rate, which is a clinically optional treatment approach.

Sacroiliac complex injuries are commonly seen in high-energy pelvic fractures. The injuries make a big difference in treatment patterns due to the diverse injury types, posing considerable challenges in formulating optimal treatment strategies, and hence are persistent clinical difficulties in orthopedic trauma. The clinical management of sacroiliac complex injuries presents several key challenges such as a non-negligible rate of missed diagnoses in associated vascular and visceral injuries, absence of standardized protocols for surgical approaches and reduction-fixation strategies across different injury patterns, and ongoing controversies regarding surgical indications and optimal timing for patients combined with concomitant lumbosacral plexus injuries. Currently, no systematic clinical guidelines are available for the diagnosis and treatment of sacroiliac complex injuries both domestically and internationally. To this end, the Pelvic and Acetabular Surgery Group, Orthopedic Branch, China International Exchange and Promotive Association for Medical and Health Care and Orthopedic Physician Branch, Chinese Medical Doctor Association organized a panel of domestic experts in the field to develop the Clinical guideline for the diagnosis and treatment of sacroiliac complex injuries ( version 2025), based on evidence-based medicine and adhering to the principles of scientific rigor, clinical applicability, and innovation. These guidelines provided 11 recommendations covering diagnosis, therapeutic principles and techniques, management protocols for lumbosacral plexus injuries, outcome evaluation, and postoperative rehabilitation pathways, etc., aiming to standardize the clinical management of sacroiliac complex injuries.

Objective:To analyze the genetic characteristics of varicella-zoster virus（VZV）in Anhui province from 2022 to 2023.Methods:Vesicle fluid and throat swab samples were collected from suspected varicella patients in Anhui province during 2022—2023. Fresh vesicle fluid samples were selected for VZV isolation，and real-time PCR was used for VZV nucleic acid detection. For positive samples，the region containing five single nucleotide polymorphism（SNP）sites in the open reading frame 22（ORF22）fragment was amplified，and PCR products were sequenced to identify viral genotypes. Reference sequences of VZV genotypes were downloaded from GenBank，sequence alignment and phylogenetic tree analysis were performed using Sequencher and MEGA5.0 software. Additionally，four SNP sites in ORF38 and ORF62 fragments were detected to distinguish vaccine strains from wild strains.Results:Among 96 samples from suspected varicella cases，55 of 61 vesicle fluid samples and 21 of 35 throat swab samples were positive for VZV nucleic acid. The virus isolation rate for vesicle fluid samples was 14.75%. Genetic sequencing was successful for 51 strains，all of which were wild strains belonging to the clade 2 genetic branch. Compared with the reference strain of clade 2，the nucleotide and amino acid homologies of the ORF22 fragment were 99.46%~100% and 98.39%~100%，respectively. One strain（2023VZVCZ45）exhibited an A→G mutation at site 37916.Conclusion:The prevalent VZV strains detected in Anhui province during 2022—2023 were all wild strains of clade 2，with no vaccine-associated cases identified.

Objective:To research access management method of evaluating medical consumables based on Kano performance classification model,so as to improve the quality of access management of medical consumables and clinical service level.Methods:The Better-Worse coefficient analysis method was adopted to analyze quantitative data,and a comprehensive performance evaluation was conducted on the basis of Kano model.And then,a classification management mode included access allocation of priority,evaluation dimensions of priority,standardization of access process and strengthening of dynamic supervision were formulated.A total of 120 kinds of medical consumables in clinical use of Jiangsu Province Hospital from January 2021 to December 2023 were selected.The expert performance evaluation model(expert performance evaluation)was adopted to conduct access management for medical consumables that were used during January 2021 and June 2022,and the Kano performance evaluation model(Kano performance evaluation)was adopted to conduct that for medical consumables that were used during July 2022 and December 2023.The performances of clinical service and operation quality of the two evaluation modes for the access of medical consumables were compared.Results:The Better coefficients of the consumables in outpatient department,emergency department and inpatient department,and consumables that were used in medical technique that adopted Kano performance evaluation mode were respectively 0.25±0.06,0.32±0.07,0.28±0.06 and 0.27±0.05,which were higher than those of that adopted expert performance evaluation mode,and the difference were statistically significant(t=4.791,4.241,5.667,5.996,P<0.05),respectively.The Worse coefficients of Kano performance evaluation mode were respectively 0.08±0.03,0.10±0.01,0.09±0.05 and 0.09±0.04,which were significantly lower than those of expert performance evaluation mode,and the differences of them were significant(t=3.431,3.049,3.324,2.979,P<0.05).The Better coefficients of operation quality performance of warehouse management,operating cost and supply of outside hospital of using Kano performance evaluation mode were respectively 0.44±0.08,0.40±0.09 and 0.22±0.06,which were higher than that of expert performance evaluation mode,and the differences were significant(t=4.052,3.563,4.792,P<0.05).The Worse coefficients of them of using Kano performance evaluation mode were respectively 0.18±0.05,0.16±0.06 and 0.10±0.04,which were lower than those of expert performance evaluation mode,and the differences were significant(t=3.347,3.438,4.092,P<0.05).Conclusion:The access management of evaluating medical consumables on the basis of Kano performance classification mode can improve the comprehensiveness and scientific nature of assessing the access of medical consumables,and enhance the level of clinical service of medical consumables,and improve the operation quality of supply management for medical consumables.

Objective:To investigate the epidemiological characteristics of human brucellosis in Yantai City of Shandong Province, and provide a basis for scientifically formulating brucellosis prevention and control strategies.Methods:A retrospective study was conducted to collect data on the epidemic situation of brucellosis in Yantai City from 2020 to 2022 from the "Infectious Disease Reporting Information Management System of China Disease Prevention and Control Information System". Descriptive analysis was conducted on the epidemic situation of brucellosis, the distribution of cases (region, time, population distributions), clinical symptoms and signs.Results:A total of 493 cases of brucellosis were reported in Yantai City from 2020 to 2022, including 129 cases in 2020, 172 cases in 2021, and 192 cases in 2022. The incidence rate was 1.905 3/100 000, 2.506 3/100 000, and 2.901 9/100 000, respectively. There were statistically significant differences between different years (χ 2 = 13.87, P = 0.001). The main distribution of brucellosis cases was in Laizhou City, Laiyang City, Zhaoyuan City, and Longkou City, accounting for 69.37% (342/493) of the total cases. Among them, Laizhou City had the highest proportion, accounting for 31.24% (154/493). There were reports of brucellosis cases in every month of the year, with the onset mainly concentrated from March to August, the cumulative cases accounted for 63.69% (314/493) of the total cases. In the population distribution, male cases were the main ones, with a male to female ratio of 2.24 ∶ 1.00 (341 ∶ 152). The age was (54.97 ± 13.59) years old, mainly concentrated in the age group of 45 - 59 years old, accounting for 43.20% (213/493). Farmers were the main occupation, accounting for 81.95% (404/493). The clinical symptoms of 493 cases of brucellosis were mainly fever, muscle and joint pain, and fatigue, accounting for 62.27% (307/493), 61.87% (305/493), and 61.46% (303/493), respectively. A few cases were accompanied by splenomegaly and hepatomegaly, accounting for 3.45% (17/493) and 1.22% (6/493), respectively. Direct contact with animals was the main route of infection for brucellosis cases, accounting for 57.00% (281/493). Conclusions:From 2020 to 2022, there are reports of brucellosis cases in every month of the year in Yantai City, with a high incidence in spring and summer. The main affected population is middle-aged male farmers, and direct contact with animals is the main route of infection. It is necessary to strengthen disease monitoring and health education for key populations during high incidence seasons.

Objective:To research access management method of evaluating medical consumables based on Kano performance classification model,so as to improve the quality of access management of medical consumables and clinical service level.Methods:The Better-Worse coefficient analysis method was adopted to analyze quantitative data,and a comprehensive performance evaluation was conducted on the basis of Kano model.And then,a classification management mode included access allocation of priority,evaluation dimensions of priority,standardization of access process and strengthening of dynamic supervision were formulated.A total of 120 kinds of medical consumables in clinical use of Jiangsu Province Hospital from January 2021 to December 2023 were selected.The expert performance evaluation model(expert performance evaluation)was adopted to conduct access management for medical consumables that were used during January 2021 and June 2022,and the Kano performance evaluation model(Kano performance evaluation)was adopted to conduct that for medical consumables that were used during July 2022 and December 2023.The performances of clinical service and operation quality of the two evaluation modes for the access of medical consumables were compared.Results:The Better coefficients of the consumables in outpatient department,emergency department and inpatient department,and consumables that were used in medical technique that adopted Kano performance evaluation mode were respectively 0.25±0.06,0.32±0.07,0.28±0.06 and 0.27±0.05,which were higher than those of that adopted expert performance evaluation mode,and the difference were statistically significant(t=4.791,4.241,5.667,5.996,P<0.05),respectively.The Worse coefficients of Kano performance evaluation mode were respectively 0.08±0.03,0.10±0.01,0.09±0.05 and 0.09±0.04,which were significantly lower than those of expert performance evaluation mode,and the differences of them were significant(t=3.431,3.049,3.324,2.979,P<0.05).The Better coefficients of operation quality performance of warehouse management,operating cost and supply of outside hospital of using Kano performance evaluation mode were respectively 0.44±0.08,0.40±0.09 and 0.22±0.06,which were higher than that of expert performance evaluation mode,and the differences were significant(t=4.052,3.563,4.792,P<0.05).The Worse coefficients of them of using Kano performance evaluation mode were respectively 0.18±0.05,0.16±0.06 and 0.10±0.04,which were lower than those of expert performance evaluation mode,and the differences were significant(t=3.347,3.438,4.092,P<0.05).Conclusion:The access management of evaluating medical consumables on the basis of Kano performance classification mode can improve the comprehensiveness and scientific nature of assessing the access of medical consumables,and enhance the level of clinical service of medical consumables,and improve the operation quality of supply management for medical consumables.

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.