OBJECTIVE To investigate the direct economic losses caused by surgical site infection(SSI)in patients undergoing orthopedic surgery and provide references for medical institutions to develop infection prevention and control measures.METHODS Clinical data of 8 207 patients undergoing orthopedic surgery from the People's Hospital of Sanshui District,Foshan City,between 2021 and 2023 were retrospectively collected.Among them,98 patients with SSI were assigned to the SSI group,while non-infected patients were included in the non-infection group.Based on a 1∶1 matched case-control principle,68 well-matched pairs of case-control samples were select-ed for comparative analysis.Key indicators such as hospitalization costs and postoperative hospital stays were de-scribed as medians,and intergroup differences were analyzed with the Wilcoxon signed-rank test.RESULTS The SSI incidence rate was 1.19％(98/8 207).Compared to non-infected patients,those with SSI had an average pro-longed postoperative hospital stay of 13.95 days,with an average direct economic loss of RMB 14 305.50 yuan per case.Direct economic losses due to SSI varied among patients with different surgical sites,age groups and wheth-er medical devices were implanted.There were statistically significant differences in the increased hospitalization costs and postoperative hospital stays between the SSI group and the non-infected group(P＜0.05).CONCLUSIONS SSI in patients undergoing orthopedic surgery leads to increased hospitalization costs,prolonged postoperative hospital stays and greater direct economic losses.Therefore,medical institutions should implement a series of efficient and targeted prevention and control measures to effectively reduce SSI incidence rate,there-by improve medical quality and patient safety.

OBJECTIVE To investigate the direct economic losses caused by surgical site infection(SSI)in patients undergoing orthopedic surgery and provide references for medical institutions to develop infection prevention and control measures.METHODS Clinical data of 8 207 patients undergoing orthopedic surgery from the People's Hospital of Sanshui District,Foshan City,between 2021 and 2023 were retrospectively collected.Among them,98 patients with SSI were assigned to the SSI group,while non-infected patients were included in the non-infection group.Based on a 1∶1 matched case-control principle,68 well-matched pairs of case-control samples were select-ed for comparative analysis.Key indicators such as hospitalization costs and postoperative hospital stays were de-scribed as medians,and intergroup differences were analyzed with the Wilcoxon signed-rank test.RESULTS The SSI incidence rate was 1.19％(98/8 207).Compared to non-infected patients,those with SSI had an average pro-longed postoperative hospital stay of 13.95 days,with an average direct economic loss of RMB 14 305.50 yuan per case.Direct economic losses due to SSI varied among patients with different surgical sites,age groups and wheth-er medical devices were implanted.There were statistically significant differences in the increased hospitalization costs and postoperative hospital stays between the SSI group and the non-infected group(P＜0.05).CONCLUSIONS SSI in patients undergoing orthopedic surgery leads to increased hospitalization costs,prolonged postoperative hospital stays and greater direct economic losses.Therefore,medical institutions should implement a series of efficient and targeted prevention and control measures to effectively reduce SSI incidence rate,there-by improve medical quality and patient safety.

Objective:To explore the feasibility and effect of remote medical education model using online film reading training to improve the ability of ophthalmologists in the Xinjiang Uygur Autonomous Region (hereinafter referred to as "Xinjiang Region" ) in diagnosing fundus diseases.Methods:The three-level film reading training system of Xinjiang Production and Construction Corps system division hospital-Corps Hospital-Peking Union Medical College Hospital was established. From June 2022 to January 2023, 4 159 posterior color fundus images were continuously collected from Department of Ophthalmology of Xinjiang Corps Hospital and 4 divisional hospitals in the Corps medical system. Among them, hypertensive retinopathy, diabetic retinopathy, exudative age-related macular degeneration (AMD), atrophic AMD and retinal vein occlusion were 3 073, 651, 43, 186 and 206 cases, respectively. The images were divided into 3 rounds (first, second and last) according to the proportion of diseases. The doctors who participated in the training (hereinafter referred to as the "training") were 15 ophthalmologists from the Corps Hospital of Xinjiang Region and the division hospital of the Corps system. There were 7 male and 8 female. Age was (38.1±4.0) years. The titles of senior, deputy senior, intermediate and junior are 1, 6, 5 and 3 respectively; Bachelor's degree and master's degree are 13 and 2 respectively. The working time of fundus disease specialty was (9.6±3.3) years. The film reading system training was conducted before the first round of labeling, and after each round of film reading, the doctors of Peking Union Medical College Hospital gave feedback and explanation on the film reading results. The diagnostic consistency, sensitivity and specificity were compared by paired sample t test. Spearman or Pearson correlation analysis was conducted between the improvement of diagnostic level and professional title, education, age and working hours of ocular fundus disease. Results:All the participating doctors completed the first, second and last reading. After each round of film reading, the film reading summary was carried out for 2 hours. The average diagnostic agreement rates of participating physicians were 53.0%, 67.0% and 75.0%, respectively. The sensitivity and specificity were 0.38, 0.69, 054 and 0.66, 0.85, 0.96, respectively. There was significant difference between the first and last examination ( P<0.001). The sensitivity of the second reading was significantly higher than that of the first reading, and the sensitivity of the last reading was significantly lower than that of the second reading, with statistical significance ( P<0.05). The specificity of the second reading was significantly higher than that of the first reading, and the last reading was significantly higher than that of the second reading, with statistical significance ( P<0.05). There was no significant correlation ( P>0.05) between the improvement of diagnostic level of participating physicians and educational background ( Rho=0.07), professional title ( Rho=0.13), age ( r=0.20), and working time of ophthalmofundus disease specialty ( r=0.26). Conclusions:Relying on the three-level online telemedicine training, it can improve the ability of ophthalmologists in Xinjiang region to diagnose fundus diseases. The preliminary telemedicine education model has demonstrated potential for feasibility and effectiveness in remote areas with inadequate medical resources.

Objective:To explore the feasibility and effect of remote medical education model using online film reading training to improve the ability of ophthalmologists in the Xinjiang Uygur Autonomous Region (hereinafter referred to as "Xinjiang Region" ) in diagnosing fundus diseases.Methods:The three-level film reading training system of Xinjiang Production and Construction Corps system division hospital-Corps Hospital-Peking Union Medical College Hospital was established. From June 2022 to January 2023, 4 159 posterior color fundus images were continuously collected from Department of Ophthalmology of Xinjiang Corps Hospital and 4 divisional hospitals in the Corps medical system. Among them, hypertensive retinopathy, diabetic retinopathy, exudative age-related macular degeneration (AMD), atrophic AMD and retinal vein occlusion were 3 073, 651, 43, 186 and 206 cases, respectively. The images were divided into 3 rounds (first, second and last) according to the proportion of diseases. The doctors who participated in the training (hereinafter referred to as the "training") were 15 ophthalmologists from the Corps Hospital of Xinjiang Region and the division hospital of the Corps system. There were 7 male and 8 female. Age was (38.1±4.0) years. The titles of senior, deputy senior, intermediate and junior are 1, 6, 5 and 3 respectively; Bachelor's degree and master's degree are 13 and 2 respectively. The working time of fundus disease specialty was (9.6±3.3) years. The film reading system training was conducted before the first round of labeling, and after each round of film reading, the doctors of Peking Union Medical College Hospital gave feedback and explanation on the film reading results. The diagnostic consistency, sensitivity and specificity were compared by paired sample t test. Spearman or Pearson correlation analysis was conducted between the improvement of diagnostic level and professional title, education, age and working hours of ocular fundus disease. Results:All the participating doctors completed the first, second and last reading. After each round of film reading, the film reading summary was carried out for 2 hours. The average diagnostic agreement rates of participating physicians were 53.0%, 67.0% and 75.0%, respectively. The sensitivity and specificity were 0.38, 0.69, 054 and 0.66, 0.85, 0.96, respectively. There was significant difference between the first and last examination ( P<0.001). The sensitivity of the second reading was significantly higher than that of the first reading, and the sensitivity of the last reading was significantly lower than that of the second reading, with statistical significance ( P<0.05). The specificity of the second reading was significantly higher than that of the first reading, and the last reading was significantly higher than that of the second reading, with statistical significance ( P<0.05). There was no significant correlation ( P>0.05) between the improvement of diagnostic level of participating physicians and educational background ( Rho=0.07), professional title ( Rho=0.13), age ( r=0.20), and working time of ophthalmofundus disease specialty ( r=0.26). Conclusions:Relying on the three-level online telemedicine training, it can improve the ability of ophthalmologists in Xinjiang region to diagnose fundus diseases. The preliminary telemedicine education model has demonstrated potential for feasibility and effectiveness in remote areas with inadequate medical resources.

Objective To investigate the effects of human leukocyte-associated antigen-G (HLA-G) expression in silencing trophoblast cell line JEG-3 under normal and hypoxic conditions on invasion and proliferation of JEG-3 cells. Methods Inhibition of HLA-G expression in JEG-3 cells by transfection of small interfering RNA (siRNA),the transfected JEG-3 cells were divided into 4 groups: normoxia control group, hypoxia control group, normoxia inhibition group and hypoxia inhibition group. The levels of HLA-G mRNA and protein in 4 groups of cells were detected by real-time quantitive PCR and western blot. The proliferation activity and invasion ability of 4 groups of cells were determined by methylthiazolyl tetrazolium (MTT) assay and invasion assay.Results (1) Real-time quantitive PCR technology showed: the level of HLA-G mRNA in the hypoxic inhibition group (0.220±0.050) was significantly different (P<0.05), when compared with that in the hypoxic control group (0.630±0.030) and normoxic inhibition group (0.400± 0.020). (2) Western blot analysis showed: the expression level of HLA-G protein in the hypoxic inhibition group was 0.260±0.010, statistically different from that in the hypoxic control group (0.850±0.100) and the normoxic inhibition group (0.560±0.020; P<0.05).(3) MTT showed: proliferative activity of JEG-3 cells in the normoxic inhibition group was 0.490 ± 0.070, the ability of cell proliferation was reduced. When compared with that in the normoxic control group (0.850±0.050), the differences was statistically significant (P<0.05). The proliferative activity of JEG-3 cells in the hypoxic inhibition group (0.330±0.070) was lower than that in the normoxic inhibition group (0.490±0.070), and there was a significant difference (P<0.05). (4) Invasion assay showed: compared with the normoxic control group (98±7), the invasive ability of JEG-3 cells in the normoxic inhibition group (73 ± 7) was weakened, and the difference was statistically significant (P<0.05). The number of transmembrane cells (52±11) of JEG-3 cells in the hypoxic inhibition group was lower than that in the hypoxic control group (72±7), and the difference was statistically significant (P<0.05). Compared with the normoxic inhibition group, the invasion ability of JEG-3 cells in the hypoxic inhibition group decreased, and the difference was statistically significant (P<0.05). Conclusion Under hypoxia, using siRNA technology to down-regulate the expression of HLA-G may affect the proliferation and invasion ability of trophoblast cells, which may be involved in the occurrence of hypertensive disorder of pregnancy.

Objective: To analyze the plague monitoring results in Ulanqab City of Inner Mongolia in 2018, to master the changes in rat density and the prevalence of plague in rats, and provide a basis for scientific prevention and control of plague. Methods: According to "The Plague Monitoring Scheme of Inner Mongolia", we surveyed Siziwang Banner, Chahar Right Back Banner, Huade County, and Shangdu County of Ulanqab City from April to November 2018 to monitor the plague. Rat density was surveyed using a one-day bow clamp method; small rodent was surveyed using a 5 m clamping method. Rodents were obtained by sample method, 5 m clamping method, daily method, collecting dead animals and the like, and fleas were picked up from the captured rats and rat nest. The rodents and fleas were carried out pathogen detection, the serum of rodents was tested by indirect hemagglutination test. Laboratory test results were analyzed based on the "Diagnostic Criteria for Plague" (WS 279-2008). Results: Totally 1 463 mice were captured overlapping a monitored area of 416 hm², the average rat density was 3.52 per hectare; the number of Meriones unguiculatus was 1 235, and the rat density was 2.97 per hectare. Totally 1 603 mice were grooming, 404 mice with fleas, the flea infected rate was 25.20%, the number of fleas were 1 348, and the flea index was 0.84. A total of 22 mouse nests were dug, 17 nests with fleas, the flea infected rate was 77.27%, the number of fleas were 131, and the flea index was 5.95. Totally 1 603 rodents were checked by etiology, the results showed that 7 plague rats were all Meriones unguiculatus. Totally 1 479 fleas of 581 groups were cultured, 14 fleas of 5 groups were detected, 3 fleas of 1 group in Siziwang Banner, and 11 fleas of 4 groups in Huade County. Totally 243 samples of murine animal serum were tested and the results were all negative. Conclusions The epidemic of plague in Ulanqab City is in an active state, so monitoring should be strengthened in this area to prevent the prevalence of human plague.

Objective To explore nursing scheduling mode in ICU. Methods Grouping was carried out on the basis of nursing decentralized management and the two-way selection between group heads and group members. The research target was the 60 nurses in ICU. Degrees of the nurses' job satisfaction and changes of nursing quality before and after grouping were compared and analyzed. Results The general degree of the nurses' satisfaction towards scheduling was (3.75±0.70) points before grouping while (4.30±0.50) points six months after grouping. The difference had the statistical significance (t=6.5645, P < 0.01);the scores of nursing quality check on classification management, ward management, nursing security, emergency management and hospital infection management were (91.97±1.47), (93.07± 1.66), (93.43 ± 1.50), (94.03 ± 1.10), (94.07 ± 1.39) points respectively before grouping and (95.08 ± 1.63), (95.77±1.55), (96.07±1.41), (97.37±1.56) and (97.07±1.48) points respectively six months after grouping. The differences had the statistical significance (t=6.5192-10.9934, P<0.01). Conclusions The two-way selection among nurses and decentralized management grouping can improve the degree of nurses′job satisfaction and nursing quality.

Objective To study the effects of single nucleotide polymorphisms (SNP) in Plasminogen activator inhibitor 1 (PAI-1) on breast cancer susceptibility and patients' prognosis among a Chinese Han women population.Methods Six tag SNP (tSNP) of PAI-1 were selected according to HapMap CHB population,and TaqMan realtime PCR method was used to genotype the 6 tSNP in 1 160 breast cancer cases and 1 318 age-matched controls among Chinese Han women.Haplotypes and diplotypes were inferred according to genotyping data and linkage disequilibrium.Finally,the associations of tSNP,haplotypes and diphypes with breast cancer susceptibility and patients' prognosis were analyzed.Results Regarding to breast cancer susceptibility,for rs6090 (G ＞ A),AA genotype carriers had 3.79 times higher risk of develoPing breast cancer (OR =4.79,95％ CI =1.01-22.64,P =0.048 0) than GG or GA genotype carriers.For rs2227672 (G ＞ T),TT genotype carriers had 1.52 times higher breast cancer risk than GG or GT genotype carriers (OR =2.52,95％ CI =1.26-5.01,P =0.008 6).Regarding to breast cancer prognosis,women who carried rs2227692 (C ＞ T) CT genotype had 46％ lower risk of developing recurrence,metastasis or death than CC genotype carriers (HR =0.54,95％ CI =0.30-0.97,P =0.040 4).Using stratified association analysis,among BMI ＜ 23 patients,those women who carried AA genotype of rs2227631 (G ＞ A) had 3.99 times higher risk of developing the events (recurrence,metastasis or death) than GG or GA genotype carriers (HR =4.99,95％ CI =1.66-15.02,P =0.004 2).Among HER2 positive patients,those women who carried AA genotype of rs2227667 (G ＞ A) had 2.98 times higher risk of developing the events (recurrence,metastasis or death) than GG or GA genotype carriers (HR =3.98,95％ CI =1.47-10.80,P =0.006 7).Among patients with tumors ＞ 2 cm,those women who carried rs2227692 (C ＞ T) CT or TT genotype had 51％ lower risk of developing the events (recurrence,metastasis or death) than CC genotype carriers (HR =0.49,95％ CI =0.27-0.88,P =0.017 0).Conclusions The study indicates that single nucleotide polymorphisms in PAI-1 may affect breast cancer susceptibility and survival in Chinese Han women.The study may contribute to individualized evaluation of breast cancer risk and patients' prognosis if these data are validated in some other Chinese Han populations.

OBJECTIVETo isolate and purify gallic acid and brevifolincarboxylic acid simultaneously by high-speed counter-current chromatography (HSCCC) from a crude extract of Polygonum capitatum.

METHODThe biphasic solvent system composed of ethyl acetate-n-butanol-0.44% acetic acid (3:1:5) was used at a flow rate of 2.0 mL x min(-1), while the aqueous phase was selected as the mobile phase and the apparatus was rotated at 860 r x min(-1). The effluent was detected at 272 nm.

RESULT51.5 mg of gallic acid and 5.9 mg of brevifolincarboxylic acid were separated from 1.07 g of the crude extract with the purities of 99.7% and 97.5%, respectively, while brevifolincarboxylic acid was obtained firstly from the genus Polygonum. The structures of the compounds were identified by ultraviolet spectrometry (UV), infra-red spectrometry (IR), liquid chromatography/mass spectrometry (LC/MS), time-of-flight mass spectrometry( TOF-MS), 1H-nuclear magnetic resonance (NMR) and 13C-NMR.

CONCLUSIONThis method is feasible and rapid for isolation and purification of gallice acid and brevifolincarboxylil acid.

Carboxylic Acids ; analysis ; isolation & purification ; Countercurrent Distribution ; methods ; Gallic Acid ; analysis ; isolation & purification ; Plant Extracts ; analysis ; isolation & purification ; Polygonum ; chemistry