Objective Exploring the construction of an electronic medical record system quality control system,impro-ving the level of hospital informatization,and providing strong support for the high-quality development of public hospitals.Meth-ods Based on the national electronic medical record system application level grading evaluation work,analyze the current situa-tion and existing problems of electronic medical record system construction in 402 hospitals participating in electronic medical re-cord grading evaluation in Zhejiang Province in 2023,and find solutions.Results To ensure the quality of electronic medical re-cord system construction,it is not only necessary to strengthen the construction of talent team,but also to strengthen the normal-ized supervision mechanism,formulate relevant quality control policies and systems,and build a multi-level quality control net-work.Conclusion The construction of electronic medical record system quality control system requires collaboration and promo-tion from multiple aspects.

Objective:To explore the characteristics of systemic immune microenvironment during the progression of dextran sulfate sodium(DSS)-induced acute ulcerative colitis(UC)induced in mice by Mass cytometry(CyTOF).Methods:Male C57BL/6 mice were randomly divided into control group and model group.The control group was given normal drinking water for 15 d.The mouse in the model group were given 5%DSS in drinking water,which was changed to normal drinking water after 7 days.In the model group,peripheral blood was collected on days 4,9 and 15,respectively.CyTOF was used to detect the expressions of 33 immune cell markers and changes in cell subsets in peripheral blood of mice,and the characteristics of systemic immune microenvironment in mice with acute UC were analyzed.Results:The cluster analysis of 33 kinds of immune cell markers showed that CD45+cells in peripheral blood of mice with DSS induced acute UC were divided into 23 fine subgroups,among which the proportions of B cell subgroup,T cell subgroup and neutrophil subgroup showed significant changes.A further dimensional reduction cluster analysis of T cell subsets found significant differences in the composition and proportion of the 10 identified T cell subsets.Conclusion:The systemic immune micro-environment map of mice with acute UC induced by DSS has been successfully constructed,and heterogeneity has been found in the systemic immune microenvironment of mice with acute UC.The changes and activation degree of T cell subpopulations are closely re-lated to disease progression and inflammation level.The results of this study provide theoretical basis for assisting the diagnosis,moni-toring the risk,progression,treatment and prognosis of acute UC.

Objective:To observe the effect of isokinetic sensorimotor training on the hand function of stroke survivors.Methods:Forty-two stroke survivors with hand dysfunction were randomly divided into an isokinetic group of 22 and a control group of 20. Both groups were given sensorimotor training in addition to routine drug treatment and rehabilitation therapy, but the isokinetic group was additionally provided with sensorimotor training based on isokinetic techniques for 45 minutes daily, 5 days a week for 4 consecutive weeks. Before and after the intervention, both groups were evaluated using the Semmes-Weinstein monofilament examination (SWME), their two-point discrimination (2-PD) was documented, proprioception of their wrist joints was quantified, and the Fugl-Meyer upper extremity assessment (FMA-UE) and the simplified upper limb function assessment (STEF) were applied.Results:In both groups after treatment, there was a significant improvement in the SWME scores and 2-PD distance of the index finger and the thenar, and there was a significant decrease in the angle of motion perception (at 30° of flexion). The average FMA-UE and STEF scores of both groups had improved. After the treatment, the SWME scores of the index finger and the thenar, as well as well as the average FMA-UE and STEF scores of the isokinetic group were significantly higher than the control group′s averages. Angle of motion perception was also significantly superior.Conclusions:Sensorimotor training based on isokinetic techniques can significantly improve touch, motion sense, gross motor function and the fine motor ability of stroke survivors.

Objective:To analyze the impact of changes in cardiovascular and cerebrovascular diseases mortality on the gender gap in life expectancy among Tianjin residents from 2004 to 2020.Methods:This is a cross-sectional study. The data sources included all-cause death surveillance data collected by the Tianjin Centre for Disease Control and Prevention, covering the entire population of Tianjin from 2004 to 2020, and the number of urban and rural residents by age, sex, and urban and rural areas from the Population Management Office of the Tianjin Public Security Bureau during the same period. The abbreviated life table and Arriaga′s decomposition method were applied to analyze the cause-of-death surveillance data of Tianjin residents from 2004 to 2020, and to calculate the impact of changes in mortality rates of cardiovascular and cerebrovascular diseases on gender differences in life expectancy by age, subcategory, and urban and rural areas.Results:In 2004, there were 56 189 deaths among Tianjin residents, including 31 233 males and 24 956 females. In 2020, there were 79 782 deaths among Tianjin residents, including 44 829 males and 34 953 females. The gender difference in life expectancy attributable to cardiovascular and cerebrovascular diseases among Tianjin residents increased from 1.52 years in 2004 to 2.02 years in 2020, with females having a longer life expectancy than males. The cumulative impact rate was higher among residents aged 40-74 years, increasing from 26.41% to 33.48%, while the cumulative impact rate among residents aged≥75 declined from 12.66% to 8.54%. The impact rates of intracerebral hemorrhage and cerebral infarction decreased significantly during the observation period, with intracerebral hemorrhage impact rate decreasing from 13.21% to 6.12% and cerebral infarction impact rate decreasing from 11.32% to 5.02%. The impact rate of acute myocardial infarction decreased but remained at a high level, from 9.70% to 6.99%. The impact rate of sequelae of cerebrovascular disease and other coronary heart diseases increased significantly, with the impact rate of sequelae of cerebrovascular disease increasing from 0.54% to 14.42% and the impact rate of other coronary heart diseases rising from 1.35% to 6.34%. The impact of sequelae of cerebrovascular disease deaths on the gender difference in life expectancy was greater in urban areas compared to rural areas, with an increase of 2 101.41% in urban areas and 1 898.51% in rural areas.Conclusions:The gender difference in life expectancy attributable to cardiovascular and cerebrovascular diseases among Tianjin residents is widening. Attention should be paid to the prevention of cerebrovascular disease sequelae and other coronary heart diseases among males aged of 40-74 years in urban areas.

Objective To investigate the occurrence of hemodialysis events in patients who received maintenance hemodialysis in outpatient setting in Liangshan Yi Autonomous Prefecture of Sichuan Province,and provide basis for the formulation of infection prevention and control strategies in this area.Methods Based on the standards from Center for Disease Control and Prevention-National Healthcare Safety Network(CDC-NHSN)as well as the WS/T 312-2023 standards,four public hospitals(two secondary and two tertiary hospitals)in three counties and one city of Liangshan Yi Autonomous Prefecture were selected,and prospective surveillance method was adopted.A total of 826 patients(n=8 675 cases)who received maintenance hemodialysis on the first two working day of each month from March 2024 to March 2025 were surveilled.Data were collected with standardized form by infection control teams in dialysis centers.Statistical analysis was conducted.Results During the surveillance period,the incidence of hemodialysis events was 5.15％(447/8 675).The incidence(16.67％,36/216)and mortality(10.00％,4/40)of hemodialysis events in patients with non-tunneled catheters were the highest among patients with all types of ac-cess.Patients with tunneled-catheters had the highest hospitalization rate(42.86％).Systemic use of antimicrobial agents accounted for 82.33％(368/447).Upper respiratory tract infection was the main infection(38.32％).In-fection at the puncture site of vascular access accounted for 16.78％(75/447).Four cases(0.89％,4/447)had positive blood culture.Conclusion Systemic antimicrobial use and infection at vascular access puncture site is the most frequent events in patients who receive maintenance hemodialysis in outpatient setting in Liangshan Yi Autono-mous Prefecture of Sichuan Province.Patients with non-tunneled catheters have the highest rate of hemodialysis events.

Objective:The performance of GeneXpert MTB/RIF (Xpert), DNA isothermal amplification fluorescence assay (DNA isothermal amplification) and RNA simultaneous amplification and testing (SAT-TB) were evaluated by detecting Mycobacterium tuberculosis in the pus samples of superficial tuberculous lymphadenitis and skeletal tuberculosis, two common extrapulmonary tuberculosis. Methods:Cross-sectional study. A total of 242 patients with suspected superficial tuberculous lymphadenitis and skeletal tuberculosis admitted to Shaanxi Provincial Tuberculosis Prevention and Control Hospital were collected from January 2022 to December 2023 and pus samples were taken from the lesions for examination. Among them, 210 patients were laboratory confirmed or clinically diagnosed with tuberculosis, 108 patients with superficial tuberculous lymphadenitis and 102 patients with skeletal tuberculosis. 32 patients without tuberculosis. Mycobacterium Tuberculosis culture, Xpert, DNA isothermal amplification, and SAT-TB detection were performed on the pus samples of all patients. The detection results were statistically analyzed using SPSS26.0 and MedCalc software. The detection effectiveness of several different detection methods for Mycobacterium tuberculosis in pus samples was compared, and P<0.05 was considered statistically significan. Results:The sensitivity of Mycobacterium Tuberculosis culture, Xpert, DNA isothermal amplification and SAT-TB in TB patients were 25.2% (53/210), 88.6% (186/210), 81.9% (172/210) and 61.0% (128/210), respectively. The area under curve (AUC) values of the four detection methods in the diagnosis of tuberculosis were 0.626, 0.943, 0.910 and 0.805, respectively. The AUC value of tuberculosis culture in the diagnosis of tuberculosis was significantly lower than that of the three molecular diagnostic techniques ( P<0.05). The AUC value of DNA isothermal amplification was significantly higher than that of SAT-TB detection method ( P<0.05). The positive tuberculosis culture was used as a reference standard where the sensitivity of Xpert, DNA isothermal amplification and SAT-TB reached 96.2%(51/53), 90.6%(48/53) and 86.8%(46/53), respectively. There was no significant difference in sensitivity among the three molecular diagnostic techniques ( P>0.05). In Xpert MTB positive patients, the positive rate of DNA isothermal amplification was 90.3% (168/186), and there was good consistency between DNA isothermal amplification and Xpert MTB detection results ( Kappa=0.765, P<0.001). Xpert detected 27 cases of rifampicin resistance, the resistance rate was 12.9% (27/210). Conclusion:GeneXpert and DNA isothermal amplification have high sensitivity and specificity in the samples of extrapulmonary tuberculosis pus, and the results of DNA isothermal amplification and GeneXpert MTB/RIF detection are highly consistent. In tuberculosis screening, DNA isothermal amplification fluorescence detection can be used for preliminary screening to reduce the detection cost.

Objective:To investigate the distribution of CGG repeat numbers in the FMR1 gene among reproductive-age women in China, providing data reference for carrier screening and genetic counseling of Fragile X syndrome. Methods:This cross-sectional study recruited 16 610 reproductive-age women from 12 medical institutions between July 2022 and October 2023. Peripheral venous blood samples (3 mL) were collected, and genomic DNA was extracted. The number of CGG repeats in the FMR1 gene was determined using the triplet-primed polymerase chain reaction (TP-PCR) combined with capillary electrophoresis technology. Statistical analyses were performed to assess the prevalence and distribution of CGG repeat expansions. Results:Among 16 610 women of childbearing age, 5 684 (34.220%) women had the same number of CGG repeats in the two alleles of FMR1 gene, and 10 926 (65.780%) women had different numbers of repeats in the two alleles. Among the 33 220 FMR1 alleles in 16 610 women of reproductive age, the most common CGG repeat numbers were 29 [48.645% (16 160/33 220)] and 30 [26.276% (8 729/33 220)], while the most frequent CGG genotype was CGG 29/29 [24.726% (4 107/16 610)]. The CGG repeat numbers of FMR1 gene were normal in 16 498 women (99.326%). Among the 112 women (0.674%) with CGG repeat abnormities, 96 (0.578%) women were classified as intermediate carriers, 15 (0.090%) as premutation carriers, and 1 (0.006%) as a full mutation carrier, whose CGG genotype was (36, >200). Conclusion:In the general reproductive-age female population in China, the normal CGG repeat numbers of the FMR1 gene account for 99.326%, while the intermediate carrier rate is 0.578%, and the combined carrier rate of the premutation and full mutation types is 0.096%.

Objective:To investigate the distribution of CGG repeat numbers in the FMR1 gene among reproductive-age women in China, providing data reference for carrier screening and genetic counseling of Fragile X syndrome. Methods:This cross-sectional study recruited 16 610 reproductive-age women from 12 medical institutions between July 2022 and October 2023. Peripheral venous blood samples (3 mL) were collected, and genomic DNA was extracted. The number of CGG repeats in the FMR1 gene was determined using the triplet-primed polymerase chain reaction (TP-PCR) combined with capillary electrophoresis technology. Statistical analyses were performed to assess the prevalence and distribution of CGG repeat expansions. Results:Among 16 610 women of childbearing age, 5 684 (34.220%) women had the same number of CGG repeats in the two alleles of FMR1 gene, and 10 926 (65.780%) women had different numbers of repeats in the two alleles. Among the 33 220 FMR1 alleles in 16 610 women of reproductive age, the most common CGG repeat numbers were 29 [48.645% (16 160/33 220)] and 30 [26.276% (8 729/33 220)], while the most frequent CGG genotype was CGG 29/29 [24.726% (4 107/16 610)]. The CGG repeat numbers of FMR1 gene were normal in 16 498 women (99.326%). Among the 112 women (0.674%) with CGG repeat abnormities, 96 (0.578%) women were classified as intermediate carriers, 15 (0.090%) as premutation carriers, and 1 (0.006%) as a full mutation carrier, whose CGG genotype was (36, >200). Conclusion:In the general reproductive-age female population in China, the normal CGG repeat numbers of the FMR1 gene account for 99.326%, while the intermediate carrier rate is 0.578%, and the combined carrier rate of the premutation and full mutation types is 0.096%.

Objective:To investigate the intervention effect of exercise rehabilitation based on constructivism teaching mode on pelvic girdle pain (PGP) in pregnant women in late pregnancy, and to provide guidance for improving the pregnancy experience of PGP pregnant women.Methods:A quasi-experimental study was conduced, from November 2023 to February 2024, using convenience sampling method to select late pregnant women with PGP who had been filed and had regular obstetric checkups in the Second Hospital of Shandong University as the study subjects, they were randomly divided into intervention group (granted exercise rehabilitation based on the constructivism teaching model) and control group (granted exercise rehabilitation based on the traditional teaching model) according to the random number table method. Compare the pain scores and teaching effectiveness of pregnant women before and after the intervention in the two groups.Results:The final number of the two groups were 50 in each group, aged (32.38 ± 3.93) years in the intervention group; aged (31.34 ± 3.19) years in the control group. After the intervention, the pain scores of pregnant women in the intervention group (1.48 ± 1.26) scores were significantly lower than those in the control group (2.96 ± 1.42) scores, and the difference was statistically significant ( t = -5.45, P<0.05). The scores of the evaluation of the teaching effect memory problem scores, movement mastery scores, and classroom evaluations were (7.96 ± 1.30) scores, (13. 96 ± 0.88) scores, (27.54 ± 3.08) scores in the intervention group, which were significantly higher than those in the control group (5.80 ± 1.29) scores, (8.48 ± 1.82) scores, (16.24 ± 3.80) scores, the differences were statistically significant ( t = 8.30, 19.16, 16.31, all P<0.05). Conclusions:Based on the constructivism teaching model, exercise rehabilitation for pregnant women with PGP in late pregnancy can effectively alleviate their pelvic girdle pain, and the teaching effect is better than the traditional teaching model, which has the potential to be promoted and applied in the teaching of obstetric maternity schools.

Objective To investigate the occurrence of hemodialysis events in patients who received maintenance hemodialysis in outpatient setting in Liangshan Yi Autonomous Prefecture of Sichuan Province,and provide basis for the formulation of infection prevention and control strategies in this area.Methods Based on the standards from Center for Disease Control and Prevention-National Healthcare Safety Network(CDC-NHSN)as well as the WS/T 312-2023 standards,four public hospitals(two secondary and two tertiary hospitals)in three counties and one city of Liangshan Yi Autonomous Prefecture were selected,and prospective surveillance method was adopted.A total of 826 patients(n=8 675 cases)who received maintenance hemodialysis on the first two working day of each month from March 2024 to March 2025 were surveilled.Data were collected with standardized form by infection control teams in dialysis centers.Statistical analysis was conducted.Results During the surveillance period,the incidence of hemodialysis events was 5.15％(447/8 675).The incidence(16.67％,36/216)and mortality(10.00％,4/40)of hemodialysis events in patients with non-tunneled catheters were the highest among patients with all types of ac-cess.Patients with tunneled-catheters had the highest hospitalization rate(42.86％).Systemic use of antimicrobial agents accounted for 82.33％(368/447).Upper respiratory tract infection was the main infection(38.32％).In-fection at the puncture site of vascular access accounted for 16.78％(75/447).Four cases(0.89％,4/447)had positive blood culture.Conclusion Systemic antimicrobial use and infection at vascular access puncture site is the most frequent events in patients who receive maintenance hemodialysis in outpatient setting in Liangshan Yi Autono-mous Prefecture of Sichuan Province.Patients with non-tunneled catheters have the highest rate of hemodialysis events.