OBJECTIVE: Blood culture remains the gold standard for diagnosing bloodstream infections. Clinical laboratories must ensure the quality of blood culture processes from receipt to obtaining definitive results. We examined laboratory analytical indicators associated with positive blood culture results. METHODS: Blood cultures collected from Peking Union Medical College Hospital between January 1, 2020, and December 31, 2022, were retrospectively analyzed. The mode of transportation (piping logistics delivery vs. staff), source of blood cultures (outpatient/emergency department vs. inpatient department), rotation of personnel, and time of reception (8:00-19:59 vs. 20:00-07:59) were compared between blood culture-positive and -negative results. RESULTS: Between 2020 and 2022, the total positive rate of blood culture was 8.07%. The positive rate of blood cultures in the outpatient/emergency department was significantly higher than that in the inpatient department (12.46% vs. 5.83%; P < 0.0001). The time-to-detection of blood cultures was significantly affected by the delivery mode and personnel rotation. The blood culture positive rate of the total pre-analytical time within 1 h was significantly higher than that within 1-2 h or > 2 h ( P < 0.0170). CONCLUSION Laboratory analytical indicators such as patient source, transportation mode, and personnel rotation significantly impacted the positive detection rate or time of blood culture.
Blood Culture/statistics & numerical data* ; Humans ; Retrospective Studies ; Emergency Service, Hospital/statistics & numerical data*

Objective To investigate the implementation of surveillance,prevention and control measures for healthcare-associated infection(HAI)in maternal and child healthcare(MCH)institutions,and provide policy evi-dence for optimizing HAI prevention and control in MCH institutions.Methods Stratified sampling was conducted among the MCH institutions at provincial,municipal and county levels in 8 provinces/autonomous regions.A uni-fied questionnaire was designed and the online survey was conducted through"Questionnaire Star".Results The data from 123 MCH institutions were included in the analysis.90.24％of the MCH institutions carried out compre-hensive surveillance on HAI.The ratios of MCH institutions which implemented targeted surveillance on HAI in neonatal intensive care unit(NICU),surgical site infection,multidrug-resistant organisms(MDROs)and HAI in intensive care units(non-NICU excluded)were 89.66％,85.96％,80.77％,and 74.19％,respectively.51.22％MCH institutions adopted information surveillance system on HAI cases.94.31％MCH institutions carried out surveillance on hand hygiene compliance.Over 90％MCH institutions carried out surveillance on environment hy-giene in high-risk departments.71.54％MCH institutions conducted centralized cleaning,disinfection,sterilization and supply for reusable medical instruments in the central sterile supply department(CSSD).Over 90％MCH insti-tutions established three-level pre-examination triage systems.86.18％set up transitional wards.MCH institutions generally adopted a management model with established effective communication,full appointment visits,and sepa-rate visits for special medical groups,such as registered pregnant women,high-risk newborns,healthcare groups,and long-term rehabilitation patients.However,the ratio of institutions conducting on-line follow-up visits was less than 50％.Conclusion MCH institutions have generally carried out comprehensive and targeted surveillance on HAI.Information surveillance need to be facilitated.Hand hygiene and environmental hygiene surveillance has been popularized to a certain extent at all levels of MCH institutions.The cleaning,disinfection,sterilization,and supply processes of reusable medical devices in a few MCH institutions are not standardized.Special medical populations get effective management.On-line healthcare is to be further promoted.

Objective To explore the imaging features of primary cardiac tumors detected by echocardiography,CT and MR in children,and to analyze the value of each examination and the clinical examination strategies.Methods The clinical,pathological and imaging data of the children with primary cardiac tumors confirmed by surgery and pathology from Jun 2008 to Feb 2022 in Children's Hospital,Fudan University were analyzed retrospectively.Tumor size,location,motion,signal characteristics on different sequences,and pericardial involvement were evaluated on MR images.Results A total of 23 children(16 males and 7 females)were included.The age of onset ranged from 1 month to 13 years old,average on(54.45±58.57)months.While the onset age of rhabdomyomas was only(7.23±6.30)months.The clinical manifestations mainly included 6 cases of cardiac murmur,3 cases of cardiac insufficiency,3 cases of epilepsy,2 cases of cerebral infarction,and 1 case of arrhythmia.Pathological results showed that there were 22 cases of benign tumors(9 cases of fibromas,8 cases of myxomas,4 cases of rhabdomyomas and 1 case of lipoma)and 1 case of malignant tumor(rhabdomyosarcoma).Echocardiography has a high diagnostic accuracy for myxoma.CT showed a case of malignant rhabdomyosarcoma with invasion of the pericardium and compression of the pulmonary artery and bronchus.MR showed that the fibroma had significantly late gadolinium enhancement.The signal of rhabdomyoma was equal on T1WI,and slightly increased on T2WI,perfusion and late gadolinium enhancement sequences.Myxoma had high signal on T2WI and late gadolinium enhancement.It had obvious motions in Cine sequence.The signal of lipoma on each sequence was consistent with that of fat tissue,and there was no high signal of perfusion and late gadolinium enhancement.Conclusion All types of primary cardiac tumors in children have imaging characteristics.MR has great advantages in diagnosing cardiac tumors.The clinical team needs to select the appropriate examination method according to the actual medical situation.

ObjectiveTo analyze and assess the pollution levels of lead （Pb）， cadmium （Cd）， and chromium （Cr） in rural soils of Wanzhou District， Chongqing Municipality， and to provide data support for proposing relevant measures and suggestions. MethodsBased on the soil monitoring data from 2017 to 2021， the ecological risk assessment was conducted by applying the Soil Pollution Risk Control Standard for Agricultural Land of Soil Environmental Quality （for trial implementation） （GB 15168‒2018）， the pollution index method and the potential ecological risk method. ResultsA total of 100 soil samples were collected， with pH values ranged from 3.50 to 8.30， and a mean value of 6.10. The mean values of Pb， Cd， and Cr in the soil were 25.2 mg·kg^-1， 0.310 mg·kg^-1， and 68.6 mg·kg^-1， respectively. Except for Cr， the mean values of other elements exceeded the soil background values. Cd level had the largest coefficient of variation and uneven spatial distribution， with an overall exceedance rate of 30.0%. Pollution levels of Pb and Cr were generally at the alert level， while Cd was generally at a light pollution level. The proportion of Cd pollution levels was higher than that of Pb and Cr， and the difference was statistically significant（χ²=15.015， P=0.001）. The Nemerow comprehensive pollution index in different townships ranged from 0.70 to 2.07， with a median value of 1.10， and was generally at a light pollution level. The potential ecological hazard risk of Cd was relatively high， and was generally at a mild level of hazard. The highest contribution rate in the comprehensive potential ecological hazard index was Cd， accounting for 84.1%. ConclusionThere is a certain degree of Cd pollution and mild ecological risk in rural soils of Wanzhou District. Monitoring and management of Cd pollution in rural soils of Wanzhou District， Chongqing Municipality， should be strengthened.

Circulating tumor DNA (ctDNA) comes from tumor, reflecting the genetic information of the tumor well, and will change with the progress of tumor. In recent years, the unique capabilities of ctDNA have attracted much attention and been widely studied. In this paper, based on the summary of the source, properties and sample processing of ctDNA, its detection technology and application in cancer diagnosis and treatment are reviewed. The roles and importance of ctDNA reference material in second-generation sequencing are described. The urgency of establishing uniform standards and specifications of ctDNA in various processes, such as samples collection, storage, quantitative testing and data analysis, has been pointed out.

The expression level of NOD-like receptors(NLRP3)inflammasome is significantly elevated in breast cancer tissues,and a high level of NLRP3 inflammasomes is closely associated with breast cancer metastasis.Activation of NLRP3 inflammasome can induce the release of inflammatory factors into the tumor microenvironment(TME).These inflammatory factors,by signaling to cancer cells,reshape the TME to promote tumor growth and invasion,ultimately facilitating the process of epithelial-mesenchymal transition.This equips cancer cells with the ability to establish distant metastases and increase the formation of metastatic lesions.This review addresses the current research status and prospects of NLRP3 inflammasomes in the breast cancer TME and their role in breast cancer metastasis.The goal is to provide new insights for the study of breast cancer metastasis mechanisms and treatment strategies.

Objective:To explore the influence of learning input and professional commitment on the core competence of rural order-oriented medical students,and to provide theoretical reference for improving the quality of the grassroots health workforce.Methods:520 rural order-oriented medical students from two medical colleges in S province were selected as research subjects.Stratified regression method was used to analyze the effect of learning input on the core competence of rural order-oriented medical students,and simple slope test was used to analyze the moderating effect of professional commitment on the aforementioned relationship.Results:The overall mean score of core competence of rural order-oriented medical students in S province was(3.39±0.549),learning input had a significant positive effect on the core competence of rural order-oriented medical students(β=0.358),and there was a moderating effect of professional commitment on the relationship between the two,which made the effect of learning input on core competence stronger(β=0.206).Conclusion:Improve the policy of training rural order-oriented medical students,strictly control the quality of admission,increase the construction and investment in grass-roots bases,emphasize students'vocational quality education,and enhance their core competencies.

Objective To investigate the distribution of traditional Chinese medicine(TCM)constitution types in patients with perimenopause metabolic syndrome in Guangzhou based on the Stages of Reproductive Aging Workshop+10(STRAW+10),so as to provide a theoretical basis for TCM constitution regulation for patients with PMS.Methods According to the diagnostic criteria of metabolic syndrome,a total of 90 patients with PMS were included.Based on the STRAW+10 staging criteria,the PMS patients were divided into early perimenopause group(-2 phase of STRAW+10,49 cases),late perimenopause group(-1 phase of STRAW+10,24cases),and early postmenopausal group(+la phase of STRAW+10,17 cases).Traditional Chinese Medicine Constitution Classification and Distinguishing Criteria were used to identify the TCM constitution types of all the subjects.At the same time,the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)were used for scoring anxiety and depression.The distribution of TCM constitution types in patients with different STRAW+10 stages was analyzed,and the SAS and SDS scores of patients with different STRAW+10 stages were compared.Results(1)The primary TCM constitution types in the early perimenopause group(-2 phase of STRAW+10)were yang deficiency constitution(14 cases,29.79％),balanced constitution(10 cases,21.28％),yin deficiency constitution(six cases,12.76％)and blood stasis constitution(six cases,12.76％).In the late perimenopause group(-1 phase of STRAW+10),the primary TCM constitution types were yang deficiency constitution(six cases,25.00％),balanced constitution(four cases,16.66％),blood stasis constitution(four cases,16.66％),qi deficiency constitution(three cases,12.50％)and phlegm-damp constitution(three cases,12.50％).In the early postmenopausal group(+la phase of STRAW+10),the primary TCM constitution types were yang deficiency constitution(seven cases,46.67％),balanced constitution(two cases,13.33％),phlegm-damp constitution(two cases,13.33％),blood stasis constitution(two cases,13.33％),qi deficiency constitution(one case,6.67％)and qi stagnation constitution(one case,6.67％).(2)The SAS score and SDS score in the early perimenopause group(-2 phase of STRAW+10)were(34.55±7.46)points and(35.55±10.61)points,respectively,which were higher than those in the late perimenopause group(-1 phase of STRAW+10)[(33.83±7.73)points and(35.46±11.35)points,respectively]and in the early postmenopausal group(+la phase of STRAW+10)[(35.65±8.67)points and(36.59±12.07)points,respectively].All of the scores were higher than the overall average level.Conclusion The TCM constitution of patients with perimenopause metabolic syndrome is predominated by yang deficiency constitution.The percentage of the balanced constitution gradually decreases with the progression of STRAW+10 staging,and the biased constitutions gradually develop from yin deficiency constitution and blood stasis constitution into qi deficiency constitution and phlegm-damp constitution,and then into phlegm-damp constitution and blood stasis constitution again.With the progression of the stage,the deficiency in the fundamental of the PMS patients becomes more deficient and the pathogens of excess in the incidental also grow.

Objective To investigate the correlation of the distribution patterns of stem-branch circuit qi at birth and at conception of children with the predisposition to pediatric epilepsy.Methods A case-control study was conducted in 1 113 children with epilepsy(case group)and 2 346 non-epilepsy children(control group)who sought medical consultation in the Pediatric Outpatient Department of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine at the same period.Chi-square test and binary logistic regression were used to analyze the circuit qi endowment of children between the two groups at conception and at birth.Results(1)The analysis of the circuit qi distribution at birth showed that there was a statistically significant difference in the distribution of dominant qi between the case group and the control group at birth(P＜0.05).The initial qi(the first circuit qi in the theory of six climatic factors)accounted for the most(215 cases,19.30％)and the sixth qi accounted for the least(145 cases,13.0％).There was no significant difference in the distribution of suiyun(yearly evolutive phase),dominant circuit(regular yearly evolutive phase),guest circuit(alterable yearly evolutive phase),guest qi(alterable yearly circuit qi)and sitian(the first half of the alterable yearly circuit qi)at birth(P＞0.05).The results of binary logistic regression analysis showed that the risk of predisposition to epilepsy in the children was increased when the children were born in the Chinese lunar year of Ren(OR=1.444,95％CI:1.055-1.975),at the initial qi(OR=1.363,95％CI:1.057-1.757)and at the fifth qi(OR=1.378,95％CI:1.065-1.783).(2)The analysis on the distribution of circuit qi at conception showed that there was no significant difference in the distribution of suiyun and sitian-zaiquan semiannual circuit qi between the case group and the control group(P＞0.05).Binary logistic regression analysis showed that the risk of predisposition to epilepsy in the children was increased when pregnancy in the suiyun of taimu-taimu(OR=1.866,95％CI:1.142-3.048)and at sitian semiannual circuit qi of shaoyang minister fire and zaiquan semiannual circuit qi of jueyin wind-wood(OR=1.672,95％CI:1.004-2.786).Conclusion There is a certain correlation between circuit qi endowment and the prevalence of pediatric epilepsy.

Objective To evaluate the diagnostic value of ischemia-modified albumin(IMA)and the crea-tine kinase(CK)index in acute ischemic stroke(AIS).Methods According to the inclusion and exclusion cri-teria,totally 149 newly diagnosed and untreated AIS patients hospitalized in Henan Provincial People's Hospi-tal from October 2021 to October 2022 were selected as the AIS group.Additionally,156 healthy people who underwent the physical examination during the same period were selected as the control group.Activity levels of IMA,CK,creatine kinase-MB(CK-MB),lactate dehydrogenase(LDH)and hydroxybutyrate-dehydrogen-ase(HBDH)were measured using the Abbott C1600 biochemical analyzer,and the CK index(ratio of CK-MB to CK)was calculated.Relative risk factors were analyzed,receiver operating characteristics(ROC)curve was constructed,data were analyzed using SPSS27.0.1,graphs were plotted using GraphPad Prism 9.4.1,and differences in area under the curve(AUC)were compared using MedCalc(version 20.0.22).Results The AIS group exhibited significantly higher levels of IMA,CK-MB,and the CK index,and significantly lower levels of CK compared to the control group(all P＜0.05).Univariate logistic regression analysis revealed that both IMA and the CK index were risk factors for AIS(both P＜0.001).After adjusting for gender and age in a multivariate binary logistic regression analysis,IMA emerged as an independent risk factor for AIS(OR=1.901,95％CI:1.649-2.190,P＜0.001).IMA,CK-MB and CK index in the AIS group were significantly higher than those in the control group,and CK levels were significantly lower than those in the control group,and the differences were statistically significant(P＜0.05).Univariate Logistic regression analysis showed that IMA and CK index were risk factors for AIS(P＜0.001).After adjusting for sex and age in multivariate binary Logistic regression analysis,IMA was an independent risk factor for AIS(OR=1.901,95％CI:1.649-2.190,P＜0.001).The ROC curve demonstrated that AUC,the sensitivity and the specificity of sin-gle detection for IMA were 0.922,81.2％,and 90.4％,respectively.There was no significant difference compared to combined detection using IMA+CK index or IMA+CK index+CK(all P＞0.05).Conclusion IMA is an independent risk factor for AIS,which has strong diagnostic value and is worthy of clinical application.