Children and adults differ significantly in physiology,biochemistry and immune function,which leads to sig-nificant differences in blood transfusion strategies between children and adults.To guide the clinical transfusion practice of pediatric patients and improve the prognosis of children,the National Health Commission organized the formulation and re-lease of the health industry standard Guideline for Pediatric Transfusion(WS/T 795-2022).This paper will briefly introduce some concepts that help understand of the Standard and the preparation process of the Standard,and explain and interpret the preparation of the"scope","general provisions"and"factors to consider"of the Standard,hoping to contribute to the understanding and implementation of the Standard.

ObjectiveTo investigate the quality of disinfection in the SARS-CoV-2 nucleic acid sampling sites in Shanghai. MethodsSwab samples of medical staff’ hands and environments of different SARS-CoV-2 nucleic acid sampling sites were collected from July to September 2022， with the total number of bacterial colonies cultured and counted. ResultsA total of 728 swab samples were collected from 69 sampling sites. The median total number of bacterial colonies on hand surface， object surface and air samples were 0 CFU·cm^-2， 0 CFU·cm^-2， and1 CFU·（petri dish∙5 min）^-1， respectively， and P₉₅ was 13 CFU·cm^-2， 5.3 CFU·cm^-2， and 17.8 CFU·（culture vessel∙5 min）^-1， respectively. According to the GB 15982‒2012 Hygienic Standard for Disinfection in Hospitals class Ⅳ environment， 680 samples met the standard （93.4%）. Furthermore， 96.9%， 92.0%， and 92.2% of the samples in the sampling sites of tertiary/secondary hospitals， community health centers， and community convenience sampling sites met the standard， respectively. Quality of disinfection did not differ significantly across these sampling sites. ConclusionThe quality of disinfection in the SARS-CoV-2 nucleic acid sampling sites in Shanghai is generally good. Additionally， hand hygiene of medical staff and disinfection on object surface in some sampling sites need to be strengthened.

Objective: To understand the knowledge of disinfection and its influencing factors among caregivers in childcare centers in Huangpu District, Shanghai, in order to provide a basis for the future development of targeted training programs and the work plan to enhance the professional level of disinfection practitioners in childcare centers. Methods: A total of 423 caregivers from 62 childcare centers (including nursery schools) in Huangpu District were selected for a questionnaire about disinfection knowledge, influencing factors, and training needs in March 2023. Differences in disinfection knowledge among subjects with different characteristics were compared using χ 2 tests, and influencing factors were analyzed using a multi factor binary Logistic regression model. Results: The overall knowledge rate of disinfection among caregivers was 50.12%, and those in public kindergartens, private ones, and nursery schools were 51.35%, 46.18%, and 42.57%, respectively, with statistically significant differences ( χ 2=14.25, P < 0.05 ). The caregivers in the highest level kindergartens ( OR =4.50, 95% CI =1.97-10.29), in first level ones ( OR =4.29, 95% CI = 1.98-9.33), in the institutions had clusters of outbreaks ( OR =1.87, 95% CI =1.14-3.07), in which the number of children to caregivers ratio being less than 10∶1 ( OR =21.81, 95% CI =2.55-186.59), with 6-14 years of working experience ( OR =3.51, 95% CI = 1.59 -7.75) had better knowledge of disinfection( P <0.05). Conclusions Knowledge of disinfection among caregivers of childcare institutions is low in Huangpu District, Shanghai. Training of caregivers disinfection knowledge should be strengthened for caregivers with fewer years of experience, in childcare institutions, to improve caregivers disinfection expertise and skills.

Objective:To evaluate the value of Sonazoid contrast enhanced ultrasound (CEUS) in preoperative prediction of proliferating cell nuclear antigen 67 (Ki-67) level of hepatocellular carcinoma (HCC) by establishing predictive model based on radiomics features of Kupffer phase.Methods:From October 2020 to August 2021, patients with histologically confirmed HCC lesion and who underwent Sonazoid CEUS examination 1 week before surgery were prospectively enrolled. The radiomics signatures were extracted from the whole tumor region on gray scale images and Kupffer phase images. Two predictive radiomics models were constructed using radiomic method. The predictive performance of 2 models was compared.Results:A total of 50 patients with histologically confirmed single HCC lesions were prospectively enrolled in this study. Among them, histological results revealed 24 HCC lesions with high level representation of Ki-67 (>20%) and 26 HCC lesions with low level representation of Ki-67 (≤20%). Two radiomics predictive models were established based on gray scale images and Kupffer phase images respectively. While compared with model based on B-mode ultrasound images, model based on Kupffer phase images showed significantly higher area under receiver operating characteristic curve (0.753 vs 0.535, P=0.017), accuracy (0.720 vs 0.580, P=0.023) and sensitivity (0.458 vs 0.250, P=0.043). Calibration plot indicated that Kupffer phase model showed better consistency with the actual Ki-67 level than gray scale model. Conclusions:The radiomics model based on Kupffer phase features of Sonazoid CEUS is a preoperative and noninvasive prediction the presentation level of Ki-67 in HCC lesions.

Objective:To quantitatively evaluate the stiffness of pancreatic parenchyma and lesions by virtual touch tissue imaging and quantification (VTIQ) technique, and to investigate the potential usefulness of ultrasound shear wave elastography (SWE) in the prediction of clinically relevant post-operative pancreatic fistula (CR-POPF) after pancreatectomy.Methods:Patients who scheduled to receive pancreatectomy were prospectively enrolled in Zhongshan Hospital, Fudan University from March 2021 to December 2021. VTIQ assessment was applied to patients within one week before the scheduled surgery to make quantitative SWE evaluation of target tissue. The SWV values of body part pancreatic parenchyma and lesions were measured and recorded. The palpation stiffness of pancreas was qualitatively evaluated during the operation by the surgeon.CR-POPF was diagnosed according to 2016 International Study Group of Pancreatic Fistula (ISGPF) standard.Grade B/C pancreatic fistula was defined as CR-POPF positive. Recognized peri-operative risk factors of CR-POPF were analyzed. ROC curve analysis was used to evaluate the diagnostic efficacy of SWV value in predicting CR-POPF.Results:A total of 72 patients were finally enrolled in this study, including 47 (65.3%, 47/72) patients who received pancreaticoduodenectomy (PD) and 25 (34.7%, 25/72) patients who underwent distal pancreatectomy. CR-POPF occurred in 22 (30.6%, 22/72) patients after pancreatectomy. The SWV value of body part pancreatic parenchyma was significant lower in CR-POPF positive group than in CR-POPF negative group ( P<0.001). There was no significant difference in lesion SWV value between CR-POPF positive and negative groups ( P=0.664). Besides, the palpation stiffness was no difference between the two groups ( P=0.689). Taking SWV value of pancreatic parenchyma >1.16 m/s as a cut-off value for predicting CR-POPF, the area under the ROC curve (AUROC) was 0.816 with 0.760 of sensitivity, 0.634 of specificity, 67.5% of positive predictive value and 72.5% of negative predictive value, respectively. Conclusions:The VTIQ method may improve the objectivity and accuracy of CR-POPF prediction via pre-operative, non-invasive and quantitative evaluation of pancreatic stiffness, which has potential value in clinical applications.

ObjectiveThis study aimed to investigate the risk factors affecting the positive detection of Acinetobacter baumannii on the hands in medical staff of hospitals in Shanghai， and provide epidemiological evidence for the prevention and control of nosocomial infections. MethodsThe hands of doctors， nurses and care workers in key departments were sampled every quarter from 2018 to 2020 according toGB 15982‒2012 "Hospital Disinfection and Hygiene Standards". Separation and identification of A. baumannii were followed with sampling shortly. Information about the working years of sampling subjects， the hand sanitizers of which sampling subjects had used and the ingredients and actual using time of the hand sanitizers was collected while sampling. Finally， 709 samples were selected for this research after excluding the unqualified samples. ResultsThe positive detection of the hand samples was 7.05%. The logistic regression model suggested that the department， the time of using hand sanitizer， the hospital grade and occupational category were determinants of A. baumannii positive detection on hands in medical staff. The risk of A. baumannii positive detection in internal medicine department was 2.846 （95%CI：1.402‒5.776） times higher than that in intensive care unit while it was 3.357 （95%CI：1.349‒8.353） times higher in surgery department than that in intensive care unit. Regarding the use of hand sanitizer， the risk of A. baumannii positive detection was 3.076 （95%CI：1.534‒6.168） times higher in the staff used the hand sanitizer over 14 days than in the medical staff used the sanitizer within 14 days. The risk of A. baumannii positive detection in medical worker in secondary hospitals was 2.235（95%CI：1.088‒4.588）times than in tertiary hospitals. The risk of A. baumannii positive detection of care workers was 3.634 （95%CI：1.764‒7.484） times higher than nurses. ConclusionThe positive detection of hand samples was 7.05%. Department， the time of using hand sanitizer， the hospital grade and occupational category were determinants of A. baumannii positive detection on hands in medical staff. It was necessary to improve hand hygiene for medical staff， especially for care worker. Cleaning and disinfection need to be strengthened in internal department and surgery department.

COVID-19 ; Coronavirus Nucleocapsid Proteins ; Humans ; Nucleocapsid Proteins ; Phosphoproteins ; SARS-CoV-2

Objective: To assess left atrial(LA)function by evaluating changes of LA wall movement and volume detected by real-time three-dimensional speckle tracking imaging(RT3D-STI)in elderly patients with ischemic mitral regurgitation(IMR). Methods: Eighty-six elderly patients with coronary heart disease(CHD)were enrolled in this study.According to whether or not to have IMR, the patients were divided into the pure CHD group(n=32)and the CHD-induced ischemic mitral regurgitation(IMR)group(n=54, including 20 cases of mild IMR, 18 cases of moderate IMR and 16 cases of severe IMR). Thirty-two healthy elderly volunteers were considered as control group.RT3D-STI was used to evaluate the global atrial longitudinal strain(GLS), global circumferential strain(GCS), global radial strain(GRS)and LA maximal, minimal and pre-systolic volumes(LAVmax, LAVmin, and LAVp). LA ejection fraction(LAEF), LA passive ejection fraction(LApEF)and LA active ejection fraction(LAaEF)were calculated.The relationship of LA volume changes and myocardial strain with LA function was analyzed. Results: The left ventricular ejection fraction(LVEF)and LAEF were reduced in CHD group and IMR group as compared with the control group, and were lower in IMR group than in CHD group(P<0.05). Compared with the control group, the LAVmin was increased, and the LAaEF was decreased in the IMR group(P<0.05). Compared with the control group, the GLS, GCS, GRS were declined in the CHD and IMR groups, and were lower in IMR group than in control group(P<0.05). Along with the increased severity of regurgitation, GLS, GCS, and GRS were decreased in varying degrees.The standard deviations of time to peak longitudinal strains(TLS-SD), of time to peak circumferential strains(TCS-SD), and of time to peak radial strain(TRS-SD)rose in the IMR group as compared with the control group(P<0.05). The myocardial motion indicators(GLS, GCS, GRS)had a quite strong correlation with LAEF in the CHD and IMR groups(CHD group: r=-0.745, -0.718 and 0.627, P=0.006, 0.007 and 0.009; IMR group: r=-0.785, -0.781, 0.643, P=0.006, 0.007 and 0.008). The receiver operating characteristic(ROC)curves analysis showed that the sensitivity and specificity of TLS-SD, TCS-SD and TRS-SD were 89.7% and 81.8%, 78.6% and 84.8%, 85.7% and 72.1%, respectively in the evaluation of LA function changes. Conclusions RT3D-STI can precisely and objectively assess the LA function changes by measuring the volume changes and tracing the myocardial motion in elderly IMR patients.

Objective:To discuss the value of real-time three-dimensional speckle tracking imaging(RT3D-STI) in the evaluation of the left atrial (LA) volume and function in end-stage renal disease (ESRD) patients with different dialysis methods.Methods:Eighty-three ESRD patients who were treated in the Affiliated Hospital of Qingdao University from February to August 2019 were enrolled and divided into non-dialysis group ( n=25), hemodialysis group (HD group, n=31) and peritoneal dialysis group (PD group, n=27). And 30 healthy volunteers were enrolled as control group. Subsequently, the LA volume indexs including LA maximal volume index (LAVImax), LA minimal volume index (LAVImin) and LA presystolic volume index (LAVIpre), the LA function parameters including LA ejection fraction (LAEF), LA passive ejection fraction(LApEF) and LA active ejection fraction (LAaEF) and the LA global strain parameters including global longitudinal strain(GLS), global radial strain(GRS) and global circumferential strain(GCS) were obtained by RT3D-STI. The differences of the parameters among these groups were compared and the correlations between the myocardial strain parameters and dialysis time were analyzed. Results:①The LAVImax, LAVImin and LAVIpre of the non-dialysis group, PD group and HD group were higher than those in the control group, while the LAEF, LApEF, GLS, GRS and GCS were lower than those in the control group(all P<0.05); the LAVImin of the PD group as well as the LAVImin, LAVIpre and LAVImax of HD group were higher than those of non-dialysis group, while the LAEF, LApEF, GLS, GCS of the PD group and the LAEF, LApEF, GLS, GRS, GCS of HD group were lower than those of non-dialysis group (all P<0.05). The LAVImax, LAVImin, LAVIpre of HD group were higher than those of PD group, while the LAEF, LApEF, GLS, GRS and GCS of HD group were lower than those of PD group (all P<0.05). ②The GLS and GCS in PD group were negatively correlated with the dialysis time( r=-0.670, -0.596, all P<0.05), and the GLS, GCS and GRS in HD group were negatively correlated with the dialysis time( r=-0.624, -0.631, -0.551, all P<0.05). Conclusions:RT3D-STI can assess the LA volume and function of ESRD patients with different dialysis methods effectively and can further evaluate the prognosis of patients and guide timely clinical intervention.

Purpose To detect left atrial volume change and myocardial strain,and to evaluate left atrial (LA) function in coronary heart disease patients with mitral regurgitation (MR) by real-time three-dimensional speckle tracking imaging (RT3D-STI).Materials and Methods Eighty-eight patients with coronary disease were divided into non mitral regurgitation group (NMR group,n=30) and mitral regurgitation group (MR group,n=58),including mild MR (n=20),moderate MR (n=20) and severe MR (n=18).Thirty healthy participants were also included as control group.Using RT3D-STI,the global atrial longitudinal strain (GLS),global radial strain (GRS),global circumferential strain (GCS),LA maximal,minimal and pre-systolic volume (LAVmax,LAVmin and LAVp),LA passive ejection fraction (LApEF) and LA active ejection fraction (LAaEF) were measured,and the relationship between LA myocardial strain and left ventricular function was analyzed.Results ① The LAEF,LVEF,LApEF in NMR group and MR group decreased compared those with the control group (P＜0.05),and the LApEF in MR group were lower than those in NMR group (P＜0.05);② compared with the control group,the GLS and GCS in NMR group and MR group decreased observably (P＜0.05),and the parameters in MR group was lower than those in NMR group (P＜0.05);along with the severity of mitral regurgitation,GLS,GCS and GRS declined in varying degrees.③ The overall strain ability of left atrial myocardium (GLS,GCS,GRS) had a positive correlation with LAEF (NMR group:r=-0.810,-0.760 and 0.851;MR group:r=-0.680,-0.745 and 0.583;P＜0.05).Conclusion RT3D-STI plays an important role in assessing LA myocardial movement change and evaluating left atrial function of mitral regurgitation patients by nvestigating left atrial volume change,calculating LAEF and tracing myocardial motion,which provides valuable references for clinical diagnosis and treatment.