Objective To analyze the implementation effect of medical risk early warning monitoring based on closed-loop complaint management.Methods A total of 453 patients admitted to the Second People's Hospital of Guizhou Province from January 2022 to December 2023 were selected retrospectively.Among them,222 patients admitted to the departments where the medical risk early warning monitoring system based on closed-loop complaint management was implemented were included in the observation group.231 patients admitted to the departments where routine medical care and complaint management were implemented were included in the control group.Risk events,complaints,medical service quality and patient satisfaction were compared between the two groups.Results The incidence rates of pressure ulcers,phlebitis,falls and other risk events were lower in the observation group than in the control group(P＜0.05),the complaint rates of examination departments and auxiliary departments and total were lower in the observation group than in the control group(P＜0.05),the complaint rates of service attitude,communication problems and medical dispute were lower in the observation group than in the control group(P＜0.05),the satisfaction rate of the observation group was higher than that of the control group(P＜0.05),the observation group had higher scores than the control group in terms of health education,communication and notification,coping capacity,specialist skills,basic skills,infection prevention and total(P＜0.05).Conclusion The medical risk early warning monitoring system based on closed-loop complaint management can reduce risk events and complaints,and improve medical service quality and satisfaction,it can achieve significant effects in practice.

OBJECTIVE To explore the value of tuberculosis infection T cell spot test(T-SPOT.TB)combined with cytokines interleukin-2(IL-2),interferon-γ(IFN-γ)in differential diagnosis of active tuberculosis(ATB)and non-ATB.METHODS A total of 186 patients with pulmonary tuberculosis(TB)who were treated in Hebei Provincial Chest Hospital from Feb.2021 to Mar.2024 were recruited as the research subjects and were divided in-to the ATB group with 92 cases and the non-ATB group with 94 cases according to the result of sputum culture for MTB,which was taken as the golden standard.The T-SPOT.TB was carried out for all of the subjects.The base-line data were collected from the two groups of patients.The hierarchical regression analysis was performed by setting the T-SPOT.TB,IL-2 and IFN-γ as the dependent variables,clinical symptoms of cough and fever as the independent variables.The impact of the clinical characteristics on T-SPOT.TB,IL-2 and IFN-γ was observed.The value of T-SPOT.TB combined with cytokines IL-2 and IFN-γ in differential diagnosis and ATB and non-ATB was evaluated by means of principal component analysis(PCA)and partial least squares discrimi-nant analysis(PLS-DA).The efficiencies of T-SPOT.TB,IL-2,IFN-γ and prediction model were examined by receiver operating characteristic(ROC)curves.RESULTS There were significant differences in cough,fever,IL-1β,IL-2,IL-6,IL-8 and IFN-γ between the two groups(P＜0.05).There were statistically positive correlations between the clinical symptoms of cough,fever and the T-SPOT.TB,IL-2 and IFN-γ(P＜0.05).The result of PCA model and PLS-DA model showed that there were less significant individual differences between the ATB pa-tients and the non-ATB patients,the two groups could be remarkably clustered and identified.The area under the curve(AUC)of the joint model was highest(0.913)(0.875 to 0.950)(P＜0.05),with the sensitivity 90.24％,the specificity 74.54％.CONCLUSION The T-SPOT.TB combined with IFN-γ and IL-2 shows high sensitivity and specificity in differential diagnosis of ATB and non-ATB and can be used as method for auxiliary diagnosis of ATB,and it has significant clinical value.

Objective To analyze the implementation effect of medical risk early warning monitoring based on closed-loop complaint management.Methods A total of 453 patients admitted to the Second People's Hospital of Guizhou Province from January 2022 to December 2023 were selected retrospectively.Among them,222 patients admitted to the departments where the medical risk early warning monitoring system based on closed-loop complaint management was implemented were included in the observation group.231 patients admitted to the departments where routine medical care and complaint management were implemented were included in the control group.Risk events,complaints,medical service quality and patient satisfaction were compared between the two groups.Results The incidence rates of pressure ulcers,phlebitis,falls and other risk events were lower in the observation group than in the control group(P＜0.05),the complaint rates of examination departments and auxiliary departments and total were lower in the observation group than in the control group(P＜0.05),the complaint rates of service attitude,communication problems and medical dispute were lower in the observation group than in the control group(P＜0.05),the satisfaction rate of the observation group was higher than that of the control group(P＜0.05),the observation group had higher scores than the control group in terms of health education,communication and notification,coping capacity,specialist skills,basic skills,infection prevention and total(P＜0.05).Conclusion The medical risk early warning monitoring system based on closed-loop complaint management can reduce risk events and complaints,and improve medical service quality and satisfaction,it can achieve significant effects in practice.

OBJECTIVE To explore the value of tuberculosis infection T cell spot test(T-SPOT.TB)combined with cytokines interleukin-2(IL-2),interferon-γ(IFN-γ)in differential diagnosis of active tuberculosis(ATB)and non-ATB.METHODS A total of 186 patients with pulmonary tuberculosis(TB)who were treated in Hebei Provincial Chest Hospital from Feb.2021 to Mar.2024 were recruited as the research subjects and were divided in-to the ATB group with 92 cases and the non-ATB group with 94 cases according to the result of sputum culture for MTB,which was taken as the golden standard.The T-SPOT.TB was carried out for all of the subjects.The base-line data were collected from the two groups of patients.The hierarchical regression analysis was performed by setting the T-SPOT.TB,IL-2 and IFN-γ as the dependent variables,clinical symptoms of cough and fever as the independent variables.The impact of the clinical characteristics on T-SPOT.TB,IL-2 and IFN-γ was observed.The value of T-SPOT.TB combined with cytokines IL-2 and IFN-γ in differential diagnosis and ATB and non-ATB was evaluated by means of principal component analysis(PCA)and partial least squares discrimi-nant analysis(PLS-DA).The efficiencies of T-SPOT.TB,IL-2,IFN-γ and prediction model were examined by receiver operating characteristic(ROC)curves.RESULTS There were significant differences in cough,fever,IL-1β,IL-2,IL-6,IL-8 and IFN-γ between the two groups(P＜0.05).There were statistically positive correlations between the clinical symptoms of cough,fever and the T-SPOT.TB,IL-2 and IFN-γ(P＜0.05).The result of PCA model and PLS-DA model showed that there were less significant individual differences between the ATB pa-tients and the non-ATB patients,the two groups could be remarkably clustered and identified.The area under the curve(AUC)of the joint model was highest(0.913)(0.875 to 0.950)(P＜0.05),with the sensitivity 90.24％,the specificity 74.54％.CONCLUSION The T-SPOT.TB combined with IFN-γ and IL-2 shows high sensitivity and specificity in differential diagnosis of ATB and non-ATB and can be used as method for auxiliary diagnosis of ATB,and it has significant clinical value.

Objective:To explore the clinical features and genetic etiology for a child with developmental delay, impaired growth, facial dysmorphism, and axonal neuropathy (DIGFAN).Methods:A child who was admitted to the Second Affiliated Hospital of Guangxi Medical University on March 22, 2021 was selected the study subject. Clinical data of the child was collected. Following extraction of genomic DNA, the child and his parents were subjected to whole exome sequencing (WES), and candidate variant was verified by Sanger sequencing and bioinformatic analysis.Results:The child, a 10-year-and-9-month-old boy, had manifested with short stature, intellectual disability, delayed speech, motor and language development, and facial dysmorphism. WES and Sanger sequencing revealed that he has harbored a novel de novo c. 800T>C (p.Leu267Pro) variant of the MORC2 gene. The Leucine at position 267, which is highly conserved among various species, is located in the S5 domain of ribosome protein in the ATPase binding region of MORC2. And the Leu267Pro may affect the function of MORC2 by altering the spatial conformation and activity of ATPase. Based on the guidelines from the American College of Medical Genetics and Genomics, the c. 800T>C variant was classified as likely pathogenic (PS2+ PM2_Supporting+ PP2+ PP3). Conclusion:The MORC2: c. 800T>C (p.Leu267Pro) variant probably underlay the pathogenesis of DIGFAN syndrome in this child.

Objectives: Despite the public-health significance of both malnutrition and crises, little has been done to explore the convergence of the two domains and develop ways to improve policies and practices, especially in rural communities. This article remedies that knowledge gap by focusing on nutrition-related changes, responses, and practices during crisis situations in Siargao Island, Philippines, using the COVID-19 pandemic as a backdrop. Methods: Forty-six (46) semi-structured interviews were conducted among parents, caregivers, local health workers, and local officials of Del Carmen, Siargao Island. Principles of thematic analysis were applied to data analysis using NVivo 12. Afterwards, the preliminary data were presented in a virtual validation session with the local community and stakeholders. Results: Despite the high prevalence of malnutrition amid a backdrop of economic and nutritional difficulties, the community members generally viewed their children as healthy. Rice remained (disproportionately) central to people’s diets; possible alternatives like root crops were considered emergency foods only and not culturally acceptable as staples, in spite of their cheap and ubiquitous nature. Lastly, the economic and financial repercussions of the COVID-19 pandemic have also negatively affected the community members’ overall nutrition and food sources. Conclusion More efforts should be directed toward encouraging the consumption of root vegetables and fruits as rice alternatives in everyday diet—a costeffective strategy that would also promote dietary diversification. More importantly, nutrition responses should consider local food systems in terms of specific local economies and geographies, while health promotion efforts should engage with local notions of ‘health’ and ‘nutrition’ and encourage community participation in (re)designing policy interventions.
Nutrition ; public health ; rice ; COVID-19

BACKGROUND:As a more common method in the orthopedic field, the method of intra-articular injection drugs has distinct curative effects, but there are some complications. In a certain extent, this method caters to the psychological fear of surgery, and can serve as a kind of conservative treatment. But some experts believed that because of the limit of sterile conditions, intra-articular injection of drugs wil increase the risk of intra-articular infection and they opposed this method.
OBJECTIVE:To review the efficacy and adverse reactions of intra-articular injection drugs in recent years, and explain clinical applications of intra-articular injection drugs in orthopedics.
METHODS:A computer-based search was conducted in PubMed and Wanfang database for articles related to the application of intra-articular injection drugs in orthopedics published between January 2007 and December 2013. The English and Chinese key words were“intra-articular, injection, orthopaedics, tranexamic acid, hyaluronic acid, corticosteroid, drugs”. Data were checked in the first trial, old articles and repetitive studies were excluded. The relevant 43 articles accorded with inclusion criteria were reviewed.
RESULTS AND CONCLUSION:In orthopedics, the method of intra-articular injection drugs is simple, economic and effective, but at the same time, there are some side effects. Tranexamic acid by intra-articular injection can significantly reduce blood loss after total joint replacement, is safety and economic. Intra-articular injection joint lubricant can reduce internal friction of joints and improve the adhesion of joint cavity, can be used as a good conservative treatment for osteoarthritis. Intra-articular injection hormone drugs can treat inflammatory arthritis, and short-term curative effect is obvious, but due to large long-term side effects, the method is not recommended now. Intra-articular injection of analgesic drugs and other drugs have both advantages complications. The efficacy of intra-articular injection drugs in orthopedics is obvious;meanwhile, this method has some complications. Orthopedic surgeons should select related drugs by indications. We stil need to further make reasonable regimen with intra-articular injection drugs in future large-scale study.

Objective To explore the characteristics of blood oxygen level dependent (BOLD) magnetic resonance imaging (MRI) in healthy native kidneys. To investigate the relationship between BOLD-MRI and common physiological in-dexes. Methods GE 3.0T MRI scanner and Torsopa phased-array coil were employed to acquire renal coronal T1WI and BOLD image. Ninety patients who were ruled out chronic kidney diseases underwent BOLD-MRI with T2*-spoiled gradient recalled echo (T2*SPGR) sequence. BOLD images were analyzed on R2*map software. Cortical and medullary R2*values were analyzed in bilateral kidneys and in different gender. Different regional R2*values in cortex and medulla were also ana-lyzed. Physiological indices including age, body height and weight, body mass index (BMI), body surface area (BSA), estimat-ed glomerular filtration rate (eGFR) were recorded. Correlation between R2*value and physiological indices were analyzed. Results Bilateral renal cortical R2*values [left (16.56±1.40) Hz and right (16.66±1.28)Hz, respectively] were less than val-ues in medulla [left (28.82±3.71)Hz and right (28.36±3.72)Hz, respectively]. Female and male cortical R2*values [female (16.55±1.30Hz) and male (16.66±1.38)Hz, respectively] were also less than corresponding values in medulla [female (28.46± 3.64) Hz and male (28.70±3.78) Hz, respectively]. In bilateral renal medullary region, R2*values in low pole (27.29±3.05) Hz was less than values in middle (29.32±3.47) Hz and upper pole (29.16±4.21)Hz (F=15.184, P<0.001). Age was positive-ly correlated with R2* values in medulla (r =0.284, P =0.002). However, eGFR was negatively correlated with medullary R2*value (r=-0.232, P=0.007). Conclusion R2*values reflected the levels of renal partial pressure of oxygen and as-sessed the degree of renal ischemia. BOLD MRI could offer a simple, convenient and noninvasive method for to evaluate renal oxygen metabolism in cortex and medulla.

BACKGROUND:Tranexamic acid has been more and more used in reducing bleeding after joint replacement, but its usage method and dosage remain controversial, and become a hot focus in recent years. OBJECTIVE:To investigate the efficacy of intra-articular injection of tranexamic acid on postoperative blood loss and limb circumference changes in patients who received unilateral total knee arthroplasty. METHODS:From March to October 2013, clinical data of 90 patients undergoing primary unilateral total knee arthroplasty were randomized to the tranexamic acid group and the control group, including 19 males and 71 females. The 30 patients in the tranexamic acid group received 50 mL of 3%tranexamic acid dilute solution inside knee joint after capsule closure, and 60 patients in the control group received the same volume of physiological saline. No significant difference in age, height, body mass index, anticoagulation, the type of prosthesis, tourniquet time and preoperative diagnosis was detected between the two groups (P>0.05). The amounts of intraoperative and postoperative blood loss and blood transfusion, postoperative drainage volume, the preoperative and postoperative limb circumference 10 cm above the operated knee were recorded. Routine blood test was reviewed after the surgery. RESULTS AND CONCLUSION:There were no significant differences in total blood loss, postoperative drainage volume and limb circumference changes between tranexamic acid and control groups (P>0.05). The amount of postoperative hidden blood loss was significantly less in the tranexamic acid group than in the control group (t=-2.683, P<0.05). These data suggested that the intra-articular injection of tranexamic acid intraoperatively in patients receiving total knee arthroplasty could significantly reduce the amounts of postoperative hidden blood loss, and did not affect the postoperative limb circumference changes.