Medical equipment, as an important indicator of smart hospital evaluation, plays a vital role in hospital operations. To ensure the safe and efficient operation of medical equipment, a reasonable performance evaluation system is indispensable. This study introduces a platform based on Internet of Things (IoT) technology that connects medical devices and collects data, achieving standardized and structured data processing, and supporting online operational supervision. Through the Delphi method, a performance evaluation system for large medical equipment is constructed, including 4 primary indicators and 22 secondary indicators. DICOM data acquisition devices are used to achieve functions such as efficiency analysis, benefit analysis, usage evaluation, and decision-making support for medical equipment. The study is still in its early stages, and in the future, it is expected to integrate more types of equipment, achieve rational resource allocation, and significantly impact decision-making for the development of public hospitals.
Internet of Things ; Delphi Technique

Objective To investigate the evaluation value of serum 25-hydroxyvitamin D[25-(OH)D],heart-type fatty acid-binding protein(H-FABP),and N-terminal pro-brain natriuret-ic peptide(NT-ProBNP)in early myocardial injury in patients with acute exacerbation of chronic ob-structive pulmonary disease(AECOPD).Methods A total of 120 patients with AECOPD(AECOPD group)were enrolled in this study.Based on the presence of early myocardial injury,they were divided into injury group(n=68)and non-injury group(n=52).Additionally,40 healthy individuals undergoing physical examinations during the same period were included as control group.The differences in serum 25-(OH)D,H-FABP,and NT-ProBNP levels were compared,and the correlations between these markers and clinical data were analyzed.Binary logistic regression analysis was used to explore the relationships between these markers and the occurrence of early myocardial injury.Receiver op-erating characteristic(ROC)curve analysis was employed to assess the diagnostic value of these markers for early myocardial injury in AECOPD patients.Results The forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),the ratio of FEV1 to FVC(FEV1/FVC),and arterial partial pressure of oxygen[pa(O2)]levels in the AECOPD group were lower than those in the control group,while the arterial partial pressure of carbon dioxide[p a(CO2)]level was high-er,with statistically significant differences(P＜0.05).The serum 25-(OH)D levels in the AECOPD group and the injury group were lower than those in the control group and the non-injury group,re-spectively,while the H-FABP and NT-ProBNP levels were higher,with statistically significant differences(P＜0.05).In AECOPD patients,serum 25-(OH)D was positively correlated with FEV1,FVC,FEV1/FVC,and pa(O2),and negatively correlated with pa(CO2)(P＜0.05).In contrast,H-FABP and NT-ProBNP were negatively correlated with FEV1,FVC,FEV1/FVC,and pa(O2),and positively correlated with pa(CO2)(P＜0.05).Binary Logistic regression analysis revealed that 25-(OH)D,H-FABP,and NT-ProBNP were related influencing factors for early myo-cardial injury in AECOPD patients(P＜0.05).ROC curve analysis showed that the areas under the curve(AUCs)for evaluating myocardial injury status based on 25-(OH)D,H-FABP,and NT-ProBNP values were 0.814,0.959,and 0.837,respectively.The AUC of their combination was 0.983,with a sensitivity of 97.06％and a specificity of 80.77％.Conclusion During early myocardial injury in AECOPD patients,there is low expression of serum 25-(OH)D and high ex-pression of H-FABP and NT-ProBNP.These three markers are correlated with early myocardial inju-ry and can serve as reference indicators for clinical diagnosis.

N⁶-methyladenosine (m⁶A) modification plays a critical role in cell cycle regulation, while the mechanism of m⁶A in regulating mitosis remains underexplored. Here, we found that the total m⁶A modification level in cells increased during mitosis by the liquid chromatography-mass spectrometry/mass spectrometry and m⁶A dot blot assays. Silencing methyltransferase-like 3 (METTL3) or METTL14 results in delayed mitosis, abnormal spindle assembly, and chromosome segregation defects by the immunofluorescence. By analyzing transcriptome-wide m⁶A targets in HeLa cells, we identified polo-like kinase 1 (PLK1) as a key gene modified by m⁶A in regulating mitosis. Specifically, through immunoblotting and RNA pulldown, m⁶A modification inhibits PLK1 translation via YTH N⁶-methyladenosine RNA binding protein 1, thus mediating cell cycle homeostasis. Demethylation of PLK1 mRNA leads to significant mitotic abnormalities. These findings highlight the critical role of m⁶A in regulating mitosis and the potential of m⁶A as a therapeutic target in proliferative diseases such as cancer.
Humans ; Polo-Like Kinase 1 ; Cell Cycle Proteins/metabolism* ; Proto-Oncogene Proteins/metabolism* ; Protein Serine-Threonine Kinases/metabolism* ; Mitosis/physiology* ; HeLa Cells ; Adenosine/genetics* ; Methyltransferases/metabolism* ; RNA, Messenger/metabolism* ; RNA-Binding Proteins/metabolism*

Objective:To detect the microbial signals in the synovial fluid from knee osteoarthritis (KOA) patients using long-read metagenomic sequencing and assess the impact of intra-articular injection of sodium hyaluronate on the detection.Methods:This retrospective study enrolled 28 KOA patients [set as a KOA group: 13 males, 15 females; mean age of (65.5±5.7) years] who had undergone primary total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA) at Department of Knee Joint Surgery, Honghui Hospital between January 2021 and January 2023. At the same time, samples of instrument cleaning water used for the 28 KOA patients were collected (set as a rinse solution group), and the knee synovial fluid was collected from 10 healthy adult volunteers [set as a control group: 5 males and 5 females; mean age of (29.7±12.1) years]. The KOA patients were stratified into an injection group ( n=5) and a non-injection group ( n=23) according to the history of injection of sodium hyaluronate within 6 months before operation. All samples were subjected to standard procedures for nucleic acid extraction and Oxford Nanopore Technologies (ONT) metagenomic sequencing to compare microbial taxa and detection frequencies. Results:No periprosthetic joint infections or infection-related clinical events occurred in the KOA patients during the 12-month postoperative follow-up. A total of 10 microbial species (30 isolates) were identified in the KOA synovial fluid (5 Gram-positive and 5 Gram-negative). The species with the top 5 detection rates were Escherichia coli (20.0%), Propionibacterium spp. (20.0%), Staphylococcus spp. (16.7%), Acinetobacter spp. (13.3%), and Pseudomonas spp. (6.7%). From the samples in the rinse solution group, 9 species (11 isolates) were detected, reflecting background contamination. All the joint fluid from the healthy volunteers in the control group was negative. Six species of microorganisms were detected in the injection group while 3 species in the non-injection group, showing a statistically significant difference ( P<0.001). Conclusions:Long-read metagenomic sequencing detects diverse microbial signatures in the synovial fluid from KOA patients, and preoperative injection of sodium hyaluronate is associated with increased detection of microbial species.

Objective:To detect the microbial signals in the synovial fluid from knee osteoarthritis (KOA) patients using long-read metagenomic sequencing and assess the impact of intra-articular injection of sodium hyaluronate on the detection.Methods:This retrospective study enrolled 28 KOA patients [set as a KOA group: 13 males, 15 females; mean age of (65.5±5.7) years] who had undergone primary total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA) at Department of Knee Joint Surgery, Honghui Hospital between January 2021 and January 2023. At the same time, samples of instrument cleaning water used for the 28 KOA patients were collected (set as a rinse solution group), and the knee synovial fluid was collected from 10 healthy adult volunteers [set as a control group: 5 males and 5 females; mean age of (29.7±12.1) years]. The KOA patients were stratified into an injection group ( n=5) and a non-injection group ( n=23) according to the history of injection of sodium hyaluronate within 6 months before operation. All samples were subjected to standard procedures for nucleic acid extraction and Oxford Nanopore Technologies (ONT) metagenomic sequencing to compare microbial taxa and detection frequencies. Results:No periprosthetic joint infections or infection-related clinical events occurred in the KOA patients during the 12-month postoperative follow-up. A total of 10 microbial species (30 isolates) were identified in the KOA synovial fluid (5 Gram-positive and 5 Gram-negative). The species with the top 5 detection rates were Escherichia coli (20.0%), Propionibacterium spp. (20.0%), Staphylococcus spp. (16.7%), Acinetobacter spp. (13.3%), and Pseudomonas spp. (6.7%). From the samples in the rinse solution group, 9 species (11 isolates) were detected, reflecting background contamination. All the joint fluid from the healthy volunteers in the control group was negative. Six species of microorganisms were detected in the injection group while 3 species in the non-injection group, showing a statistically significant difference ( P<0.001). Conclusions:Long-read metagenomic sequencing detects diverse microbial signatures in the synovial fluid from KOA patients, and preoperative injection of sodium hyaluronate is associated with increased detection of microbial species.

Objective To deposit degradable amino-hybrid mesoporous silica(AHMS)in situ on the surface of tita-nium nanotube(TNT)and explore its protective effect on nanomorphology and osteogenesis.Methods TNT and TNT@AHMS were sequentially prepared via an anodizing method:the oil-water two-phase method(experimental group)and the acid-etched titanium method[control group(Ti)].The parameters for synthesis were explored by changing the silicon source dosage ratio(3∶1,1∶1,1∶3);the surface morphology was observed by scanning electron microscope(SEM),hydrophilicity was detected by Water Contact Angle Tester,elemental composition was detected by X-ray photo-electron spectroscopy(XPS);nanoindentation test and ultrasonic oscillator were used to observe the morphological hold-ing effect as mechanical strength of TNT@AHMS in vitro;simulated immersion experiments in vitro was used to observe the degradation behavior of the material.the MC3T3-E1 cell line was used to observe the effect of cell adhesion,prolif-eration and differentiation on the material;and an SD rat femoral implant model and micro-CT were used to verify the protective effect and osseointegration effect of AHMS on TNT morphology.Results The morphologies of TNT and TNT@AHMS were successfully prepared,and the silicon source ratio was 1∶3.SEM showed that the titanium nanotubes were uniformly covered with AHMS coating,and the mesoporous pore size was about 4 nm.After AHMS was incorporat-ed,the surface of the material was hydrophilic(12.78°),the presence of amino groups(NH2-)was detected,the material was completely degraded within 12 h in vitro,and the active morphology of the TNT was re-exposed with a cumulative silicon release of 10 ppm.Nanoindentation test showed that TNT@AHMS exhibited more ideal surface mechanical strength.SEM revealed that TNT maintains its own morphology under the protection of AHMS,and the TNT group suf-fered severe exfoliation.In addition,the early adhesion and proliferation rates,ALP activity,and bone volume fraction of cells on the TNT@AHMS surface 4 weeks after implantation were significantly higher than those in the TNT group.Con-clusion By depositing AHMS on the surface of TNT,the nanotopography can be protected.It not only prevents the ac-tive base topography from exerting subsequent biological effects but also further endows the material with the ability to promote bone regeneration,laying a foundation for the future development of nanotopography-modified titanium im-plants.

Objective To analyze the genetic etiology of a fetus with growth restriction,short long bones,small head circumference and enhanced kidney echoes,and explore the clinical significance of nonsense mutations in the NIPBL gene.Methods The clinical data of the fetus and his/her parents were collected.The variation sites of the NIPBL gene were verified by the chromosome karyotype a-nalysis of amniotic fluid,copy number variation detection in the human genome(CNV-seq),whole exome sequencing(WES)and Sanger sequencing.The databases such as China National Knowledge Infrastructure(CNKI),Wanfang Data,Wanfang Medical,and Pubmed were searched to further analyze the relationship between clinical symptoms and gene mutation sites in the fetus.Results The sequencing results showed that there was c.4555A>T heterozygous mutation in exon 21 of the NIPBL gene in the fetus,and that the same mutation was not detected in his/her parents.The above variation had not been included in databases such as Human Exon Data-base(ExAC),1000 genomes(1000G)and Genome Aggregation Database(gnomAD),and were comprehensively judged as harmful variation.Conclusion The detection of the nonsense variation,c.4555A>T(p.Lys1519?),in the NIPBL gene may provide experi-mental evidence for the prenatal diagnosis and fertility in this family.

Objective: To investigate the prevalence and influencing factors of latent tuberculosis infection (LTBI) among students close contacts diagnosed with pulmonary tuberculosis in Baoshan District, Shanghai, so as to provide the basis for the prevention and control of pulmonary tuberculosis among students. Methods: Pulmonary tuberculosis cases identified among students or teaching staff were selected as index cases through the Surveillance System of Chinese Disease Prevention and Control Information System, school reports, notification of Centers for Disease Control and Prevention from April 2021 to November 2023, and student close contacts in their schools were selected as research subjects. Demographic information, lifestyle and Mycobacterium tuberculosis test results were collected through questionnaires surveys and pulmonary tuberculosis screening. LTBI was defined as a positive Mycobacterium tuberculosis test result with the exclusion of active pulmonary tuberculosis. The influencing factors for LTBI among student close contacts were identified using a multivariable logistic regression model. Results: A total of 1 212 student close contacts were included, with 651 males and 561 females, resulting in a gender ratio of 1.16︰1. The mean age was (18.48±4.33) years. Among them, 32 cases were detected with LTBI, yielding a detection rate of 2.64%. Higher LTBI detection rates were observed among students who shared the same dormitory with pulmonary tuberculosis cases (9.26%), attended private schools (5.54%), lived on campus (3.54%), and obtained meals through take-out services (6.52%). Multivariable logistic regression analysis showed that sharing the same dormitory with pulmonary tuberculosis cases (OR=3.604, 95%CI: 1.256-10.338), attending a private school (OR=2.327, 95%CI: 1.083-5.003), and three meals a day through canteens (OR=9.561, 95%CI: 2.029-45.057) or through take-out services (OR=19.222, 95%CI: 3.528-104.732) were associated with a higher risk of LTBI. Conclusion The close contacts of students with pulmonary tuberculosis in Baoshan District are at risk of LTBI, which is mainly affected by the degree of contact with tuberculosis cases, the strength of school epidemic prevention and control, and students' eating habits.

Objective:To explore the application value of Oxford nanopore technologies (ONT) in the diagnosis and treatment of periprosthetic joint infection (PJI).Methods:A prospective analysis was conducted on 32 patients with PJI admitted to the joint department of Xi'an Honghui Hospital from October 2021 to March 2023, who met the 2018 PJI diagnostic criteria of the American Skeletal Infection Society (MSIS), including 15 males and 17 females with an average age of 63.93±8.93 years. 32 revision patients who did not meet the 2018 MSIS PJI criteria during the same period were collected as controls (non PJI group), including 13 males and 19 females with an average age of 65.53±8.54 years. All patients underwent joint fluid puncture before or during surgery, and the specimens were tested by ONT, metagenomic next generation sequencing (mNGS), and general microbial culture. The receiver operating characteristic (ROC) curves were drawn for both groups, and the sensitivity, specificity, positive predictive value, negative predictive value, and Youden index of the three detection techniques were calculated and compared to evaluate the detection efficiency of different detection methods in PJI.Results:Among the 32 patients with PJI, 30 were positive for ONT, with a total of 30 pathogenic bacteria detected, and the detection time was 22.37±8.36 h. 31 were positive for mNGS, with a total of 33 bacterial species detected, and the detection time was 46.25±9.36 h. 17 were positive for microbial culture, with a total of 8 bacterial species detected, and the detection time was 96.23±15.62 h. Among the 32 patients with non PJI group, 1 was positive for ONT and 5 were positive for mNGS, with a total of 1 and 3 bacterial species detected, respectively. The results of microbial culture were all negative. The detection time and area under the curve (AUC) of ONT and mNGS were 22.37±8.36 h and 0.953[95% CI (0.901, 1.006)], 46.25±9.36 h and 0.906[95% CI (0.835, 0.977)], respectively, which were better than those of microbial culture 96.23±15.62 h and 0.766[95% CI (0.678, 0.853)], and the difference was statistically significant ( P<0.05). The sensitivity of ONT, mNGS, and microbial culture were 0.938, 0.969, and 0.531, respectively, and the specificity was 0.969, 0.844, and 1.000, respectively. The Jordan index was 0.906, 0.813, and 0.531, respectively. Conclusion:ONT testing has higher diagnostic efficacy than mNGS and microbial culture in the diagnosis of PJI, and also has advantages in detection time. It also suggests that some PJI are not caused by a single microbial infection.

Objective:To explore the characteristics of intestinal microbiota in patients with systemic lupus erythematosus (SLE), and further explore the relationship between microbiota and CD4 +T lymphocyte subsets and disease activity. Methods:Fecal samples were collected from 96 patients with SLE, and 96 sex- and age-matched healthy controls (HCs). The gut microbiota were investigated via 16s rRNA sequencing. Flow cytometry was used to detect peripheral CD4 +T lymphocyte subsets of Th1, Th2, Th17 and Treg cells. Indicators of disease activity such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), complement C3 and C4, Systemic lupus erythematosus disease activity index(SLEDAI) for each patient were recorded. Differential abundance analysis was carried out using the edgeR algorithm. The Wilcoxon rank-sum test was used to compare alpha diversity indices, bacterial abundances, and the F/B ratio between groups. R (version 4.0.1) was used for comparative statistics, and Pearson′s correlation analysis was used to assess the correlations between the relative abundances of bacterial genera and serum levels of ESR, CRP, C3 and C4 in the samples. Results:The alpha estimators of richness (ACE and Chao 1) were significantly reduced in SLE feces samples compared with those of HCs ( P<0.01). Bacterial diversity estimators, including the Shannon ( P<0.01) and Simpson′s ( P<0.01) indices, were also significantly lower in SLE. Significant differences in gut microbiota composition between SLE and HCs were found using the edgeR algorithm. Compared with HC, 24 species of bacteria were significantly different in SLE patients at the genus level ( P<0.05). Moreover, there was a significant positive correlation between CRP and Coprococcus ( r=0.30, P=0.014), C4 and Corynebacterium ( r=0.31, P=0.013) and Faecalibacterium( r=0.25, P=0.048), Hemoglobin and Morganella( r=0.41, P=0.001), as well as SLIDA and Corynebacterium( r=0.25, P=0.047). In terms of lymphocyte subsets, there was significant positive correlation between B cells, Treg cells and Eubacterium eligens group, as well as CD8 +T, CD4 +T, NK cells and Corynebacterium. In additional, Th1 was positively correlated with Shigella Escherichia coli ( r=0.52, P=0.008), and Th2 was positively correlated with Dielma ( r=0.51, P<0.001). Conclusion:The abundance and diversity of intestinal flora in SLE patients were significantly reduced, and the differentially expressed bacteria were closely related to the CD4 +T lymphocyte subsets and disease activity indicators of patients.