Objective:To explore the current status of hospital-acquired rhinosinusitis (HAR) in Neurocritical Care Unit (NCU) patients and to analyze its risk factors.Methods:From January 2021 to December 2022, 819 NCU patients of Nanfang Hospital, Southern Medical University were selected by whole population sampling method, of which 125 patients met the inclusion and exclusion criteria for analysis. Patients were categorized into HAR group ( n=69) and non-HAR group ( n=56) based on the occurrence of HAR. Differences in demographic and clinical data of the two groups of patients were compared. Logistic regression analysis was used to explore the risk factors for the HAR in patients. Results:HAR occurred in 69 NCU patients, with an incidence of 55.2% (69/125) . There were statistically significant differences in gender, smoking history, Glasgow Coma Scale score on admission, whether or not there was pneumonia, whether or not a nasogastric tube was indwelt before the occurrence of HAR, whether or not tracheal intubation was performed before the occurrence of HAR, whether or not mechanical ventilation was conducted before the occurrence of HAR, whether or not tracheotomy was performed, and the length of NCU stay between patients in HAR group and non-HAR group ( P<0.05) . Logistic regression analysis showed that indwelling nasogastric tube before the occurrence of HAR, failure to quit smoking before admission, and prolonged NCU stay were risk factors for HAR ( OR=6.291, 3.976, 1.089; P<0.05) . Conclusions:NCU patients have a high incidence of HAR, and indwelling nasogastric tube, failure to quit smoking before admission, and prolonged NCU stay are risk factors for HAR in NCU patients.

Object:To explore the feasibility of using artificial intelligence for quality control of echocardiographic images.Methods:Retrospectively，5 000 two-dimensional echocardiographic video images within the period from 2021 to 2023 were randomly retrieved from the echocardiography database of Nanjing Drum Tower Hospital，Affiliated Hospital of Medical School，Nanjing University. Among these selected images，1 559 of them were apical views. The physician team formulated the scoring rules，which specifically included four scoring criteria：gain，scaling ratio，cardiac axis angle，and structure. Subsequently，the data were labeled with view classification and image quality scores. The labeled data were further partitioned into the training set（ n = 643），the validation set（ n = 276），and the test set（ n = 640）. The training and validation sets were utilized for constructing the models for view classification and quality assessment，while the test set was employed to verify the models' effectiveness. The view classification module was implemented using the SlowFast model，and the quality assessment module involved algorithms such as ResNet，Video Swin Transformer，SSD，and U-Net. Results:The average accuracy，precision，recall rate and F1 score of the classification model in identifying each apical view were 0.987 1，0.983 0，0.987 1 and 0.984 9 respectively，and the inference time was（333.4 ± 105.4）ms. The average accuracies of the quality assessment module in terms of gain，scaling ratio，cardiac axis angle and display of main structures were 0.915 1，0.928 2，0.938 7 and 0.965 6 respectively，and the overall scoring accuracy was 0.912 7.Conclusions:The echocardiogram quality control system developed in this research can effectively classify and evaluate the quality of two-dimensional images of the apical views in echocardiograms. Moreover，it guarantees the objectivity，timeliness and high-efficiency of quality control，which has reference value for the establishment of the echocardiogram quality control system.

Objective:To explore the current status of hospital-acquired rhinosinusitis (HAR) in Neurocritical Care Unit (NCU) patients and to analyze its risk factors.Methods:From January 2021 to December 2022, 819 NCU patients of Nanfang Hospital, Southern Medical University were selected by whole population sampling method, of which 125 patients met the inclusion and exclusion criteria for analysis. Patients were categorized into HAR group ( n=69) and non-HAR group ( n=56) based on the occurrence of HAR. Differences in demographic and clinical data of the two groups of patients were compared. Logistic regression analysis was used to explore the risk factors for the HAR in patients. Results:HAR occurred in 69 NCU patients, with an incidence of 55.2% (69/125) . There were statistically significant differences in gender, smoking history, Glasgow Coma Scale score on admission, whether or not there was pneumonia, whether or not a nasogastric tube was indwelt before the occurrence of HAR, whether or not tracheal intubation was performed before the occurrence of HAR, whether or not mechanical ventilation was conducted before the occurrence of HAR, whether or not tracheotomy was performed, and the length of NCU stay between patients in HAR group and non-HAR group ( P<0.05) . Logistic regression analysis showed that indwelling nasogastric tube before the occurrence of HAR, failure to quit smoking before admission, and prolonged NCU stay were risk factors for HAR ( OR=6.291, 3.976, 1.089; P<0.05) . Conclusions:NCU patients have a high incidence of HAR, and indwelling nasogastric tube, failure to quit smoking before admission, and prolonged NCU stay are risk factors for HAR in NCU patients.

Object:To explore the feasibility of using artificial intelligence for quality control of echocardiographic images.Methods:Retrospectively，5 000 two-dimensional echocardiographic video images within the period from 2021 to 2023 were randomly retrieved from the echocardiography database of Nanjing Drum Tower Hospital，Affiliated Hospital of Medical School，Nanjing University. Among these selected images，1 559 of them were apical views. The physician team formulated the scoring rules，which specifically included four scoring criteria：gain，scaling ratio，cardiac axis angle，and structure. Subsequently，the data were labeled with view classification and image quality scores. The labeled data were further partitioned into the training set（ n = 643），the validation set（ n = 276），and the test set（ n = 640）. The training and validation sets were utilized for constructing the models for view classification and quality assessment，while the test set was employed to verify the models' effectiveness. The view classification module was implemented using the SlowFast model，and the quality assessment module involved algorithms such as ResNet，Video Swin Transformer，SSD，and U-Net. Results:The average accuracy，precision，recall rate and F1 score of the classification model in identifying each apical view were 0.987 1，0.983 0，0.987 1 and 0.984 9 respectively，and the inference time was（333.4 ± 105.4）ms. The average accuracies of the quality assessment module in terms of gain，scaling ratio，cardiac axis angle and display of main structures were 0.915 1，0.928 2，0.938 7 and 0.965 6 respectively，and the overall scoring accuracy was 0.912 7.Conclusions:The echocardiogram quality control system developed in this research can effectively classify and evaluate the quality of two-dimensional images of the apical views in echocardiograms. Moreover，it guarantees the objectivity，timeliness and high-efficiency of quality control，which has reference value for the establishment of the echocardiogram quality control system.

OBJECTIVE To study the structural characteristics of purified polysaccharide isolated from Polygonatum cyrtonema Hua and explore its anti-fatigue and intestinal bacteria improvement effects,so as to provide theoretical basis for the development of products using this polysaccharide as functional ingredients.METHODS PMP pre-column derivatization-high performance liquid chromatography,trimethylsilyl ether derivatization-gas chromatography and other methods were used to chemically characterize the pu-rified polysaccharide;the mouse weight-loading swimming test and biochemical indicators were used to evaluate its anti-fatigue effect;16S rRNA intestinal flora sequencing was adopted to study the effect of the purified product in improving intestinal bacteria.RESULTS The obtained polysaccharide was a fructan product and contained small amounts of glucose(Glc),galactose(Gal),arabinose(Ara),mannose(Man),rhamnose(Rha)and galacturonic acid(GalA),which had a relative molecular mass in the range of 0.4-285 kDa,and the molecular weight of the main component was around 3 kDa.Compared with the model group,the high-dose polysaccha-ride group could significantly prolong the exhaustive swimming time of mice(P＜0.01),reduce the levels of BUN and UA in serum and the LA(P＜0.01)and MDA levels(P＜0.05)in muscle tissue,and enhance SOD(P＜0.01),GSH-Px(P＜0.001)and CAT(P＜0.05)levels in liver tissue.Compared with the blank control group,the low-dose polysaccharide group could increase the relative a-bundance of probiotics Eggerthelaceae(g_unclassified_f_Eggerthelaceae)and Weissella(g_Weissella)in the fecal microorganisms of mice(P＜0.05).CONCLUSION The chemical composition of purified polysaccharide isolated from Polygonatum cyrtonema Hua is determined,and it is proven that the polysaccharide has a good anti-fatigue effect and can promote the growth of probiotics in the intes-tine,which provides a basis for product development using this polysaccharide as a functional ingredient.

Objective:To understand the epidemiology of rubella and the genetic characteristics of the virus circulating during the period 2021-2022, providing basic scientific data for rubella prevention and control in China.Methods:National rubella incidence data for the period 2021-2022 were obtained from the Infectious Disease Surveillance System module and the Surveillance Report Management module of the China′s Disease Prevention and Control Information System. Positive rubella virus(RuV)isolates were obtained from the National Measles/Rubella Laboratory Network. Two nucleotide (nt) fragments [F1-480 (8 633-9 112 nt) and F2-633 (8 945-9 577 nt)] located in the E1 gene were amplified and determined by reverse transcription polymerase chain reaction (RT-PCR), and the target gene (E1-739) was obtained after collating and splicing. The sequences obtained in this study were used to construct a phylogenetic tree with the reported reference strains for genotype and lineage identification. Additionally, the phylogenetic analysis was performed to assess their genetic relatedness of RuV strains prevalent in China during 2018-2020 from GenBank database.Results:In 2021-2022, the rubella incidence in China was 0.06/100, 000 (2021: 840 cases; 2022: 784 cases), with cases primarily concentrated in the western and southern provinces. Age distribution analysis showed that rubella cases in 2021-2022 was mainly in children under 5 years of age (2021: 34.17%, 287/840; 2022: 42.09%, 330/784), with the highest proportion in children aged 0-2 years. Further analysis of the immunization history of cases revealed that in the 8-23 months age group, a significant proportion of cases had received only one dose of rubella containing vaccine (RCV); cases in the 2-14 years age group were mainly among children who had received two or more doses of RCV; however, cases over 15 years of age were primarily found in individuals who had not received RCV or had unknown immunization history. National virological surveillance data showed that totally 22 RuV virus isolates were obtained, from 6 provinces in China during 2021-2022, which belonged to lineage 1E-L2 (11 strains) and 2B-L2c (11 strains). And these viruses displayed high genetic homology with RuV prevalent from 2018 to 2020.Conclusions:The incidence of rubella in China was maintained at a low level during 2021-2022, and the prevalent RuV strains were lineage 1E-L2 and 2B-L2c.

Objective To explore the value of deep learning(DL)models semi-automatic training system for automatic optimization of clinical image quality control of transthoracic echocardiography(TTE).Methods Totally 1 250 TTE videos from 402 patients were retrospectively collected,including 490 apical four chamber(A4C),310 parasternal long axis view of left ventricle(PLAX)and 450 parasternal short axis view of great vessel(PSAXGv).The videos were divided into development set(245 A4C,155 PLAX,225 PSAXGV),semi-automated training set(98 A4C,62 PLAX,90 PSAXGV)and test set(147 A4C,93 PLAX,135 PSAXGV)at the ratio of 5:2:3.Based on development set and semi-automatic training set,DL model of quality control was semi-automatically iteratively optimized,and a semi-automatic training system was constructed,then the efficacy of DL models for recognizing TTE views and assessing imaging quality of TTE were verified in test set.Results After optimization,the overall accuracy,precision,recall,and F1 score of DL models for recognizing TTE views in test set improved from 97.33％,97.26％,97.26％and 97.26％to 99.73％,99.65％,99.77％and 99.71％,respectively,while the overall accuracy for assessing A4C,PLAX and PSAXGV TTE as standard views in test set improved from 89.12％,83.87％and 90.37％to 93.20％,90.32％and 93.33％,respectively.Conclusion The developed DL models semi-automatic training system could improve the efficiency of clinical imaging quality control of TTE and increase iteration speed.

ObjectiveTo understand the experience， knowledge and attitudes of e-cigarette users in Shanghai， and to provide evidence for the development of intervention programs for e-cigarette use. MethodsThe Respondent-Driven Sampling （RDS） method was used to recruit 40 e-cigarette users for qualitative interviews from November 2020 to February 2021. NVivo （11.0） software was used to code interview records， and the thematic pattern and relationship analysis were conducted. ResultsIn terms of the reasons and user experience of e-cigarette use， most respondents used e-cigarettes for the first time after recommendation of friends； The reasons for the current use of e-cigarettes focus on the subjective feelings generated by the use of e-cigarettes （easy to use， replacing traditional tobacco， and having many flavors）. Compared with traditional tobacco use， respondents said e-cigarettes tasted good and had no physical impact （they could be used all the time without making them uncomfortable）. In terms of the awareness of e-cigarette use related knowledge， the respondents' opinions on whether e-cigarettes caused health risks were mostly based on their own experience of using them， and they said it was difficult to identify real information online. As for whether they were interested in relevant knowledge， most respondents said they wanted to learn about the professional knowledge related to e-cigarettes. Regarding the attitude related to the use of e-cigarettes， most respondents believed that e-cigarettes are addictive， e-cigarettes are not a safe alternative to traditional tobacco， ande-cigarettes couldn't help them quit smoking. Three out of ten respondents said they supported including e-cigarettes in the Regulation on Smoking Control in Public. ConclusionThere are certain characteristics of e-cigarette users' feelings， related knowledge and attitude towards e-cigarette use that should be targeted to carry out publicity， education and intervention.

AIM: To evaluate the effect of TDF withdrawal time on changes of serum HBV-M, HBV DNA and ALT level in the mother-to-child blocking of the maternal population. METHODS: A prospective, randomized and controlled study was conducted. The 120 pregnant women with HBV who took TDF during 24 to 28 weeks of gestation were randomly divided into group A (withdrawal at delivery) and group B (withdrawal at 4 weeks postpartum), levels of HBV-M, HBV DNA, and ALT at different times were detected. The results were statistically analyzed by Wilcoxon Rank-sum test and χ

OBJECTIVE: To complete standardized management and follow-up for the cancer pain and chronic pain patients in outpatient department. METHODS: Information management platform was designed and established for cancer pain and chronic pain patients in outpatient department, including information entry, information inquiry, prompt for drug dispensing in advance, file unified management and regular scanning and removing excess medical records. The procedure of prescribing narcotic drugs for first visiting, subsequent visiting and follow-up patients was introduced. File management and prescription rationality before and after the establishment of information platform were compared. The adoption of pharmacist' s recommendation after the establishment of information platform were counted. RESULTS: Compared with before the establishment of information platform, the ratio of problematic profiles decreased from 42. 96％ to 7. 06％ (P＜0. 05); the ratio of irrational prescription decreased from 4. 39％ to 1. 19％ (P＜0. 05). Pharmacists provided a total of 1 542 recommendations for the patients with poor pain control and ADR. The adoption rate of the pharmaceutical recommendations was 63. 62％. CONCLUSIONS: The cancer pain and chronic pain information management platform can manage the outpatients' profile effectively and improve the rationality of the prescription. Meanwhile, the pharmacists have played an important role in the pain treatment for outpatients.