Objective To evaluate the current situation of disease control in middle-aged and elderly patients with chronic obstructive pulmonary disease (COPD) and analyze the relationship with disease cognition. Methods Among the 360 middle-aged and elderly COPD patients diagnosed and treated in our hospital from January 2022 to June 2024 were retrospectively selected as research subjects, and the COPD Assessment Test Questionnaire (CAT), COPD Patient Knowledge Questionnaire (BCKQ) and the hampion Health Belief Model Scale were used to evaluate disease control, disease cognition and health beliefs in COPD patients. The Pearson chi-square test was used to analyze the relationship between disease control level and disease cognition and health beliefs in older patients with COPD. Results A total of 360 middle-aged and elderly COPD patients, 112 were in the complete control group, 189 were in the partial control group, and 59 were in the uncontrolled group, the disease control rate was 83.61%. The differences in disease cognitive scores, severity cognition, susceptibility cognition, disorder cognition, benefit cognition, health motivation, self-efficacy score and total health belief scores in middle-aged and elderly COPD patients with different disease control conditions are statistically significant. The scores of the complete control group were higher than those of partial control group and uncontrolled group, and the scores of partial control group were higher than those of the uncontrolled group (P <0.05). The disease control level of middle-aged and elderly patients with COPD is positively correlated with disease cognitive level and health belief in all dimensions. The higher the disease control level, the higher the disease cognitive level and health belief in the patient . Conclusions Middle-aged and elderly COPD patients still have insufficient awareness of the disease, and the level of disease control needs to be improved. There is a significant correlation between disease cognition, health beliefs and the level of disease control, and the improved cognitive level may help to improve the disease management and control effect. For middle-aged and elderly COPD patients, the community can provide health education courses, personalized health guidance and self-management training to enhance their awareness of diseases, so as to improve the long-term management of COPD and the quality of life of patients.

The construction of an information system for equipment budget management in public hospitals is an important measure to strengthen comprehensive budget management, serving as an important foundation for promoting the development of clinical disciplines and enhancing operational management. Since September 2023, a tertiary public hospital had explored the construction of equipment budget management informatization. This practice had established a supporting budget management information system, which included an equipment demand reserve library and a general use product library, linked performance evaluation indicators, implemented visualizing real-time project progress, and strengthened data governance. A series of measures had been taken to move management to equipment demand research, expand the time window for departments to fill in budget requirements, simplify the department application process, and achieve a closed-loop management of the entire chain of department equipment demand research, budget approval, and execution, ensuring the rationality and accuracy of the budget. By the end of 2024, the budget management information system had covered 87 departments and included 30 000 sets of equipment applications, providing detailed data support and critical management references for demand departments, equipment management departments, and hospital decision-makers, while improving the quality and efficiency of in-hospital equipment management. This practice could provide references for other public hospitals in China to optimize their equipment budget management.

Objective To investigate the effect of uterine distension fluid temperature on the body tem-perature and pain degree of the patients with abnormal uterine bleeding caused by endometrial polyps during hysteroscopy diagnosis and treatment.Methods A total of 114 patients who visited the hysteroscopic clinic of this hospital from April 2022 to April 2024 were enrolled as the study subjects.The patients were randomly divided into two groups by using the simple random allocation method.The group A(n=51)used the warm 0.9％sodium chloride solution at 36-37 ℃ as the uterine distention solution,while the group B(n=63)used a room temperature 0.9％sodium chloride solution at 22-23 ℃ as the uterine distention solution.During the diagnosis and treatment process,thevisual analog scale(VAS)was used to assess the degree of pain.The VAS scores before surgery(T0),entering the vagina(T1),passing through the cervical internal opening(T2),ente-ring the uterine cavity(T3),during operation(T4),at the end of surgery(T5),and at 30 min after surgery end(T6)were compasred between the two groups;the body temperatures at T0,T5 and T6 were compared be-tween the two groups.Results There was no statistically significant difference in the body temperature at T0 time point between the two groups(P＞0.05).The body temperature at T5 and T6 time points in the group A was higher than that in the group B,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the VAS scores at T0 and T6 time points between the two groups(P＞0.05).The VAS scores at T1,T2,T3,T4 and T5 time points in the group A were lower than those in the group B,and the differences were statistically significant(P＜0.05).Conclusion The application of warm uterine distention solution in hysteroscopy diagnosis and treatment could maintain the stable body temperature of the patients,reduce the severity of pain,thus increases the patient comfort level.

Objective:To report the nationwide surveillance results of pathogenic profiles and antimicrobial resistance patterns of Gram-positive bloodstream infections in China in 2023.Methods:The clinical isolates of Gram-posttive bacteria from blood cultures were collected in member hospitals of National Bloodstream Infection Bacterial Resistant Investigation Collaborative System（BRICS）during January to December 2023. Antimicrobial susceptibility testing was performed using the dilution method recommended by the Clinical and Laboratory Standards Institute（CLSI）. Statistical analyses were conducted using WHONET 5.6 and SPSS 25.0 software.Results:A total of 4 385 Gram-positive bacterial isolates were obtained from 60 participating center. The top five pathogens were Staphylococcus aureus（ n=1 544，35.2%），coagulase-negative Staphylococci（ n=1 441，32.9%）， Enterococcus faecium（ n=574，13.1%）， Enterococcus faecalis（ n=385，8.8%），and α-hemolytic Streptococci（ n=187，4.3%）. The prevalence of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococci（MRCNS）was 26.2%（405/1 544）and 69.8%（1 006/1 441），respectively. Notably，all Staphylococci remained susceptible to glycopeptide or daptomycin. Staphylococcus aureus demonstrated excellent susceptibility（>97.0%）to cephalobiol，rifampicin，trimethoprim-sulfamethoxazole，linezolid，minocycline，tigecycline，and eravacycline. No Enterococcus exhibiting resistance to linezolid were detected. Glycopeptide resistance was uncommon but more frequent in Enterococcus faecium（resistance to vancomycin and teicoplanin：both 1.7%）compared to Enterococcus faecalis（both 0.3%）. The detection rates of MRSA and MRCNS exhibited significant regional variations across the country（ χ2=17.674 and 148.650，respectively，both P<0.001）. No vancomycin-resistant Enterococci were detected in central China. Institutional comparison demonstrated higher prevalence of MRSA（ χ2=14.111， P<0.001）and MRCNS（ χ2=4.828， P=0.028）in provincial hospitals than that in municipal hospitals. Socioeconomic analysis identified elevated detection rates of both MRSA（ χ2=18.986， P<0.001）and MRCNS（ χ2=4.477， P=0.034）in less developed regions（per capita GDP

Objective:To report the results of bacterial resistant investigation collaborative system（BRICS）on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2023，and provide reference for clinical tretment of bloodstream infections and prevention and control of bacterial resistance.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of BRICS were collected during January 2023 to December 2023. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 were used to analyze the data.Results:During the study period，11 492 strains of Gram-negative bacteria were collected from 60 hospitals，of which 10 098（87.9%）were Enterobacterales and 1 394（12.1%）were non-fermentative bacteria. The top 5 bacterial species were Escherichia coli（50.0%）， Klebsiella pneumoniae（26.1%）， Pseudomonas aeruginosa（5.1%）， Acinetobacter baumannii complex（5.0%）and Enterobacter cloacae complex（4.1%）. The ESBL-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus mirablilis were 46.8%（2 685/5 741），18.3%（549/2 999）and 44.0%（77/175），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（76/5 741）and 15.0%（450/2 999）；32.9%（25/76）and 78.0%（351/450）of CREC and CRKP were sensitive to ceftazidime/avibactam combination，respectively. 94.7%（72/76）and 90.2%（406/450）of CREC and CRKP were sensitive to aztreonam/avibactam combination. Furthermore，57.9%（44/76）and 79.1%（356/450）were sensitive to imipenem/relebactam combination. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 64.6%（370/573），while more than 80.0% of CRAB complex was sensitive to tigecycline，eravacycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 17.0%（99/581）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of important Gram-negative bacteria resistance among different regions in China，with statistically significant differences in the prevalence of CREC，CRKP，CRPA and CRAB complex（ χ2=10.6，28.6，10.8 and 19.3， P<0.05）. The prevalence of ESBL-producing Escherichia coli， CREC，CRAB complex and CRKP were higher in provincial hospitals than those in municipal hospitals（ χ2=12.5，9.8，12.7 and 57.8，all P<0.01）. Conclusions:Gram-negative bacteria are the main pathogens causing bloodstream infections in China，and Escherichia coli is ranked in the top，while the trend of Klebsiella pneumoniae increases continuously with time. CRKP infection shows a slow upward trend，CREC infecton maintains a low prevalence level，and CRAB complex infection continues to exhibit a high prevalence rate. The composition and resistance patterns of pathogens causing bloodstream infections vary to some extent across different regions and levels of hospitals in China.

Objective:To investigate the effect of monocular form deprivation (MD) on the distribution density of neuregulin-1 (NRG1) + and NRG1 - parvalbumin (PV) neurons in the primary visual cortex of mice during the critical period of visual development. Methods:Twelve healthy 28-day-old SPF male C57BL/6J mice were randomly divided into control group and MD group by the random number table method, with 6 mice in each group.After MD on postnatal day (P) 28, the MD group was fed until P32, while the control group was fed normally until P32.All mice were sacrificed by cervical dislocation after cardiac perfusion, and brain tissues were quickly collected.After fixation overnight, brain slices were subjected to PV and NRG1 immunofluorescence staining to observe and compare the differences in the distribution density of PV + , PV + /NRG1 + and PV + /NRG1 - neurons in both sides of the primary visual cortex (V1) area of the two groups.This study was conducted in accordance with the Regulations on the Administration of Experimental Animals (2017 Revision), and the study protocol was approved by the Institutional Animal Care and Use Committee of Tianjin Medical University (No.TMUaMEC2022004). Results:Immunofluorescence staining showed that the density of PV + and PV + /NRG1 + neurons was (137.8±4.3), (108.8±4.1), (137.4±4.0)/mm 2 in the contralateral V1 area of the control group, MD group and the ipsilateral V1 area of the MD group, and that of PV + /NRG1 + neurons was (112.0±4.6), (82.1±4.7) and (113.6±5.7)/mm 2, respectively, with statistically significant overall differences ( F=15.88, 12.53; both P<0.001).PV + neuron density and PV + /NRG1 + neuron density in the contralateral V1 area of the MD group were significantly lower than in the control group and in the ipsilateral V1 area of the MD group (all P<0.001).There was no difference in PV + /NRG1 - neuron density between the two groups ( F=0.20, P>0.05). Conclusions:PV + /NRG1 + neurons may be the main cell type regulating the development of primary visual cortex during the critical period.

Objective:To evaluate the cost-effectiveness of interventional bronchoscopy with rigid bronchoscopy(scleroscope),laryngeal mask airway and endotracheal intubation access for the treatment of central airway stenosis.Methods:The data of patients with central airway stenosis who underwent interventional bronchoscopy under general anesthesia were collected,and divided into rigid bronchoscopy group,laryngeal mask group and tracheal intubation group.The average Cost-Effectiveness Ratio(CER)was calculated using total hospitalization cost and total surgery cost as the cost indices,and improvement of shortness of breath symptoms as the effect index.The stability of the evaluation result was analyzed by one-factor sensitivity analysis and probabilistic sensitivity analysis.Results:A total of 205 patients were included:rigid bronchoscopy group(66 patients),laryngeal mask group(64 patients)and tracheal intubation group(75 patients).The CERs were 8 851.29 for the rigid bronchoscopy group,10 942.62 for the laryngeal mask group,and 8 902.98 for the tracheal intubation group when using total hospitalization cost as the cost index.For total surgery cost,the CERs were 2 617.80,3 389.73,and 2 741.38,respectively.The order was rigid bronchoscopy＜tracheal intubation＜laryngeal mask.The main factors affecting the model results were the discount rate,non-surgical costs,and improvement of shortness of breath symptoms.Probabilistic sensitivity analysis shows that the results of the basic analysis are stable.Conclusion:Interventional bronchoscopy via rigid bronchoscope is the most economical method for treating central airway stenosis.

Objective:To conduct a systematic review and Meta-analysis of unavoidable pressure injuries (uPI) to provide evidence-based guidance for establishing standardized intervention protocols.Methods:Cross-sectional and cohort studies on uPI were systematically retrieved from PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang, and China Biology Medicine disc databases up to February 5, 2024. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in the included studies. Meta-analysis was performed using R4.3.2 software.Results:A total of 9 studies involving 10 research items were included. The Meta-analysis showed that the proportion of uPI was 42.92%. Subgroup analysis revealed that the proportions of uPI in acute care hospitals, intensive care units, and long-term care facilities were 53.14%, 33.56%, and 40.97%, respectively. The proportions in North America and Europe were 40.26% and 44.99%, respectively. The proportions of uPI in studies published between 2010-2015, 2016-2020, and 2021-2024 were 63.25%, 37.00%, and 40.61%, respectively. The proportions of uPI assessed using the Pressure Ulcer Prevention Inventory, National Pressure Ulcer Advisory Panel definition, empirical judgment, NHS definition, and end-stage pressure injury definition were 40.38%, 26.17%, 40.00%, 62.07%, and 51.32%, respectively.Conclusions:The incidence of uPI is high, with significant differences across healthcare settings, continents, years, and assessment criteria. A universal definition of uPI should be established, along with unified assessment standards, to optimize uPI care strategies and provide references for standardized prevention and intervention.

Objective:To investigate the effect of monocular form deprivation (MD) on the distribution density of neuregulin-1 (NRG1) + and NRG1 - parvalbumin (PV) neurons in the primary visual cortex of mice during the critical period of visual development. Methods:Twelve healthy 28-day-old SPF male C57BL/6J mice were randomly divided into control group and MD group by the random number table method, with 6 mice in each group.After MD on postnatal day (P) 28, the MD group was fed until P32, while the control group was fed normally until P32.All mice were sacrificed by cervical dislocation after cardiac perfusion, and brain tissues were quickly collected.After fixation overnight, brain slices were subjected to PV and NRG1 immunofluorescence staining to observe and compare the differences in the distribution density of PV + , PV + /NRG1 + and PV + /NRG1 - neurons in both sides of the primary visual cortex (V1) area of the two groups.This study was conducted in accordance with the Regulations on the Administration of Experimental Animals (2017 Revision), and the study protocol was approved by the Institutional Animal Care and Use Committee of Tianjin Medical University (No.TMUaMEC2022004). Results:Immunofluorescence staining showed that the density of PV + and PV + /NRG1 + neurons was (137.8±4.3), (108.8±4.1), (137.4±4.0)/mm 2 in the contralateral V1 area of the control group, MD group and the ipsilateral V1 area of the MD group, and that of PV + /NRG1 + neurons was (112.0±4.6), (82.1±4.7) and (113.6±5.7)/mm 2, respectively, with statistically significant overall differences ( F=15.88, 12.53; both P<0.001).PV + neuron density and PV + /NRG1 + neuron density in the contralateral V1 area of the MD group were significantly lower than in the control group and in the ipsilateral V1 area of the MD group (all P<0.001).There was no difference in PV + /NRG1 - neuron density between the two groups ( F=0.20, P>0.05). Conclusions:PV + /NRG1 + neurons may be the main cell type regulating the development of primary visual cortex during the critical period.

Objective:To evaluate the cost-effectiveness of interventional bronchoscopy with rigid bronchoscopy(scleroscope),laryngeal mask airway and endotracheal intubation access for the treatment of central airway stenosis.Methods:The data of patients with central airway stenosis who underwent interventional bronchoscopy under general anesthesia were collected,and divided into rigid bronchoscopy group,laryngeal mask group and tracheal intubation group.The average Cost-Effectiveness Ratio(CER)was calculated using total hospitalization cost and total surgery cost as the cost indices,and improvement of shortness of breath symptoms as the effect index.The stability of the evaluation result was analyzed by one-factor sensitivity analysis and probabilistic sensitivity analysis.Results:A total of 205 patients were included:rigid bronchoscopy group(66 patients),laryngeal mask group(64 patients)and tracheal intubation group(75 patients).The CERs were 8 851.29 for the rigid bronchoscopy group,10 942.62 for the laryngeal mask group,and 8 902.98 for the tracheal intubation group when using total hospitalization cost as the cost index.For total surgery cost,the CERs were 2 617.80,3 389.73,and 2 741.38,respectively.The order was rigid bronchoscopy＜tracheal intubation＜laryngeal mask.The main factors affecting the model results were the discount rate,non-surgical costs,and improvement of shortness of breath symptoms.Probabilistic sensitivity analysis shows that the results of the basic analysis are stable.Conclusion:Interventional bronchoscopy via rigid bronchoscope is the most economical method for treating central airway stenosis.