Objective To investigate the relationships of serum procalcitonin(PCT),α1-acid glycoprotein(α1-AGP)and cluster of differentiation 64(CD64)index with the severity of illness and prognosis in patients with pulmonary Candida infection after lung cancer surgery.Methods A pro-spective study was conducted in 120 patients with pulmonary Candida infection after lung cancer sur-gery as infection group,and 60 patients without infection after lung cancer surgery in the same period were selected as control group.Baseline characteristics and laboratory indicators were compared be-tween the two groups.Differences in serum PCT,α1-AGP,CD64 index in peripheral blood,and plasma 1,3-β-D glucan test(BG)were compared among patients with different severities of illness and prognoses in the infection group.The relationship between serum indicators and prognosis as well as their predictive efficiencies were analyzed,and external validation was performed.Results The levels of serum PCT,α1-AGP,CD64 index in peripheral blood,and plasma BG in the infection group were significantly higher than those in the control group(P＜0.05).In the infection group,the levels of serum PCT,α1-AGP,and CD64 gradually decreased significantly in patients with severe,moderate,and mild illness,and the levels of these indicators in dead patients were significantly higher than those in surviving patients(P＜0.05).Survival curve analysis showed that patients with low levels of serum PCT,α1-AGP,and CD64 index before treatment had higher survival rates than those with high levels of these indicators.Receiver operating characteristic(ROC)curve analysis revealed that the combined prediction of PCT,α1-AGP,and CD64 index for mortality was superior to individual indicators or their pairwise combinations,and external validation confirmed the good predictive efficacy of the combined prediction.Conclusion PCT,α1-AGP,and CD64 index are closely related to pulmonary Candida infection after lung cancer surgery,and the combined detection of these indicators has certain predictive value for 28-day prognosis.

Objective : To investigate the effect of environmental enrichment on cognitive impairment and hippo- campus GAP-43 changes induced by exposure to obstructive sleep apnea-hypopnea syndrome ( OSAHS) during the period of late pregnancy in mice，and to explore relative inflammatory pathway mechanism． Methods : The experi- mental group of C57BL/6J pregnant mice were exposed to an intermittent hypoxic environment for 7 consecutive days starting from gestational day 15．The corresponding offspring were then placed in an enriched environment from postnatal day 21 to 2 months of age (designated as OSAHS + EE group) or in a normal environment (designat- ed as OSAHS group) ．Pregnant mice in the control group were maintained in a normal oxygen environment，and their corresponding offspring were placed in an enriched environment (designated as Control + EE group) or a nor- mal environment (designated as Control group) at the same ages．The spatial learning and memory ability of the mice was assessed by Morris water maze at the age of 2 months．The mRNA levels of NF-kB，NLRP3 and GAP-43 in the hippocampus were detected by real-time fluorescence quantitative PCR , and the protein levels of NLRP3 and GAP-43 in the hippocampus were detected by Western blot． Results: Compared with Control group，the swimming distance increased (P＜0. 01) ，and the percentage of swimming distance in target quadrant decreased (P＜0. 01) in OSAHS group．The level of NF - κB mRNA，NLRP3 mRNA and protein in the hippocampus was increased，and the level of GAP-43 mRNA and protein was decreased (P＜0. 01) ．Compared with the Control group，there were no significant differences in swimming distance，percentage of swimming distance，NF-κB mRNA，NLRP3 mRNA and protein content in the OSAHS + EE group． Conclusion OSAHS during pregnancy impairs the learning and memory ability of offspring mice and reduces the level of GAP-43 protein．The mechanism may be related to the in- crease of NF-κB / NLRP3 level，and environmental enrichment can improve the damage．

Nosocomial infection poses a significant threat to patient safety and increase their disease burden. Outbreaks of nosocomial infection are the main harmfulness associated with nosocomial infection, which making them socially sensitive issues. Nosocomial infection surveillance and warning are core contents of nosocomial infection management. Accurate early warning technology for nosocomial infection outbreaks can reflect the management capability of infection prevention and control. This study designed an early warning system based on a multi-dimensional and multi-scale comprehensive information surveillance mode for nosocomial infection outbreaks which was launched in March 2023. This system extracted the process-related indicators of nosocomial infection from various hospital information systems into the nosocomial infection database center. Under the multi-dimensional and multi-scale surveillance mode, the process-related data were stratified according to the predefined dimensions and scales, then generating time-series datasets of numerous subgroups. The system conducted weekly for all time-series datasets of subgroups based on warning rules, and subsequently sent out warning signals to managers. These warning signals could be verified by managers through data check, case verification and epidemiological investigation. Once a nosocomial infection outbreak was confirmed, intervention measures could be implemented promptly. In practical application, the system generated warning signals for nosocomial infection clusters in 12 departments on August 7th, 2023. The traditional nosocomial infection case report system ultimately reported 54 nosocomial infection cases, which distributed across 13 departments, with clusters(more than 3 cases) observed in 6 departments. All these 6 departments received warning signals generated from our system. It has been demonstrated that our system could predicted the nosocomial infection clusters 5.3 days earlier than the traditional nosocomial infection case report system on average, with warning sensitivity of 100.0% and positive predictive value of 50.0%. Early warning under the multi-dimensional and multi-scale comprehensive information surveillance mode was able to transform the work pattern of nosocomial infection outbreaks control and management from passive to active. Particularly it has advantages in early detection for occult outbreaks, providing a valuable support for improving nosocomial infection management capability.

Objective In order to discuss the rationality of clinical use of medication and the strategies of serious adverse reactions(SADR),the reports of SADRs caused by nedaplatin for injection were summarized and analyzed.Methods Methods Serious adverse reactions to all medicines reported to the National Adverse Reaction Monitoring Centre(NARMC)in Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology from January 2012 to December 2021 were collected,and a retrospective analysis of 90 patients among those cases with SADR after nedaplatin injection was carried out.Results The occurrence of SADRs was not related to the gender.In monotherapy with nedaplatin,the rate of serious adverse effects was high with the first use of nedaplatin(74.3%).The incidence of adverse reactions was highest within 30 minutes and 2-14 days,including severe allergic reaction(34.4%)and grade Ⅱ-Ⅳ myelosuppression(51.2%),respectively.Drug withdrawal and symptomatic treatment were often the preferred treatment methods in clinical practice.Conclusion While using nedaplatin as a chemotherapy regimen,especially for the first time,patients should be closely monitored for the occurrence of severe anaphylaxis within 30 minutes and severe bone marrow suppression within 2 weeks.A rescue emergency plan for resuscitation and regular checking of the hemogram should be made to prevent the occurrence of serious adverse reactions.

The policy implementation model of G. C. Edwards was used to analyze the public policy health impact assessment in Zhejiang province, and summarize its practice and existing problems in four aspects of policy implementation standards, policy resources, policy executors′ intention and management organization structure, so as to provide reference for promoting the national health impact assessment pilot work. The analysis results showed that Zhejiang province has initially established the public policy health impact assessment mechanism and achieved phased results, but there were still some problems, including the imperfection of policy content and implementation strategy, the inadequacy of leadership decision-making and top-level design, the difference in attitude, understanding and implementation preference of policy implementation subjects, and the ambiguity of the authority and responsibility system of each department in cooperation. In order to further promote the smooth development of public policy health impact assessment, Zhejiang province should actively promote the top-level design to strengthen policy support, integrate and optimize policy resources, gradually establish and improve the health governance mechanism of multiple and overall coordination, and promote the high-quality development of public policy health impact assessment by taking cross departmental cooperation as the path of health co-construction.

Objective: To conduct economic evaluation of treatments under dental general anesthesia (DGA) and protective stabilization (PS), in order to compare the cost and the final therapeutic effect of these two treatments. Methods: Retrospectively studied twenty-six 2 to 4 years old patients treated under DGA and twenty-seven treated under PS in the Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology. The general information, treatment information and total treatment cost information of patients were collected. The cost and cost-survival time ratio of the two groups were compared in units of people and tooth respectively. When compared in unit of people, patients were divided into two groups depending on the number of teeth treated, when compared in unit of tooth, teeth were divided into two groups depending on the treatment received, i.e. restoration or root canal treatment. In addition, we recalculated and compared two groups under the assumption that the treatment charges of DGA was consistent with common outpatient charges. Results: The tooth average cost and cost-survival time ratio of each patient in DGA group which were [(1 133.87±87.37) yuan] and [3.51 (1.30, 5.72) yuan/d] respectively were significantly higher than those in PS group which were [(303.81±155.34) yuan] and [1.54 (0.95, 2.13) yuan/d] respectively (P<0.01). The number of teeth and the way of treatments wouldn't change the result. The recalculated result of the cost-survival time ratio of each patient in DGA group [1.63 (0.72, 2.55) yuan/d] and PS group [1.54 (0.95, 2.13) yuan/d] showed no significant difference (P=0.455). Conclusions Patients treated in Peking University School and Hospital of Stomatology showed a significant higher cost and cost-survival time radio in DGA group than that in PS group. If the treatment charges of DGA group was consistent with common outpatient charges, PS group will no longer have economic advantage.

Objective To demonstrate the influence of stress on attentional bias in athletes,in order to make guidance for athletes' attention training and control.Method Using dot-probe paradigm,we analyzed the attention behavior of 25 athletes either under stress or not when viewing different pictures of emotional face.The reaction time and the score of the attention bias were recorded and compared.Result The reaction time to negative face pictures under stress was significantly shorter than that to the positive and neutral ones.The value of the attention bias to negative pictures was significantly bigger than O.Conclusion Stress tends to induce attention bias of athletes to negative information.

Objective To explore the influence of visual searching training on attentional bias and stress response of athletes,in order to make guidance for their attention training before competition.Method Thirty-two athletes were given the visual searching training once every two days for 4 weeks.Before and after the training,the attention behavior of athletes was evaluated using the dot-probe task,and the stress response in stressful condition was evaluated using the rating of perceived exertion and heart rate variability(HRV).Result After the visual searching training,less stress,anxiety level and attention to negative information were observed in the stressful condition.Moreover,a decrease was also found in the ratio between low frequency and high frequency,and the low frequency normalized of HRV,while an increase was found in the high frequency normalized.Conclusion Visual searching training can lower the stress response and negative attentional bias for athletes in stressful condition.

Objective: To investigate echocardiography characteristics and clinical significance in patients with diastolic mitral regurgitation. Methods: A total of 15 patients with diastolic mitral regurgitation were studied including 1 patient with large volume of aortic regurgitation, 6 with atrial ifbrillation (AF), 2 with atrial lfutter, 1 with II° type I atrio-ventricular block (A-V block), 1 with II° type II A-V block and 4 with III° A-V block. The characteristics of mitral regurgitation were observed, the heart rates, left ventricular size were measured and left ventricular function was detected in all patients. Results: There was 1 large volume aortic regurgitation patient with diastolic mitral regurgitation occurred in slow iflling phase with less volume, it was less than positive velocity; 1 AF patient occurred in mid and late diastolic phase with less volume, it was obviously less than positive velocity; the rest 8 patients all occurred in mid and late diastolic phase, the velocity reached or surpassed to positive velocity. All 15 patients had slow heart rate, increased left heart, decreased left ventricular ejection fraction, tissue Doppler imaging showed that the early diastolic peak slowed down in mitral ring. There were 93% (14/15) patients having obvious systolic regurgitation. Conclusion: The time phase, quantity and velocity of diastolic mitral regurgitation have various characteristics, most of them associated with systolic regurgitation combining abnormal cardiac structure and function. Echocardiography provides important information for clinical treatment.

Objective To measure the sizes of patent ductus arteriosus (PDA) by echocardiography,compare the results with those by X-ray angiography(XA),to analysis the correlation of measurements between echocardiography and XA,to explore the value of echocardiography on screening the size of PDA suitable for transcatheter occlusion.Methods One hundred and forty-one participants was included.The parameters of PDA including the length of PDA(PDAL),the aortic side diameter (PDADao) and the pulmonary side diameter of PDA(PDADpa) were measured from the parasternal great artery short-axis view (PSSA) and the suprasternal descending aorta long-axis view(SSLA) of echocardiography and left lateral projection of XA,and the other parameters such as the left ventriclular end-diastolic diameter index (LVEDDI),the main pulmonary artery diameter index(MPADI),the pressure drop of PDA shunt (△P) and the pulmonary artery systolic pressure index(PASPI) were measured by echocardiography.The sizes of PDA from PSSA,SSLA and XA were compared,and the correlations of the sizes of PDA between echocardiography and XA,the correlations between the other parameters by echocardiography and the PDADpa index(PDADIpa) by XA(PDADIpa-XA) and PSSA(PDADIpa-PSSA) were analyzed.Results ①The difference of the sizes of PDA:Between PSSA and SSLA had difference on mersurement of PDA(all P ＜ 0.05),except SSLA had no difference on measurement of PDADao with XA (P ＞0.05),others echocardiography parameters all had difference on measurement of PDA with XA (all P ＜ 0.05).②Correlation:Both PSSA and SSLA had positive correlations with XA (all P ＜0.01).And among these parameters,PDAL by SSLA,PDADao by SSLA and PDADpa by PSSA had better correlations with XA (r =0.92,0.87 and 0.91,respectively,all P ＜0.01).LVEDDI,MPADI and PASPI had positive correlations with PDADIpa (all P ＜0.01),the LVEDDI and MPADI had better correlations with PDADIpa-PSSA(r =0.76,0.72,all P ＜0.01),but the PASPI had a better correlation with PDADIpa-XA(r =0.70,P ＜0.01).PASP had a negative correlation with △P (r =-0.79,P ＜0.01).Conclusions There was difference between the sizes of PDA at different echocardiographic views,PDADpa by PSSA and the PDAL and the PDADao by the SSLA were more close to those parameters by XA.Multiplane views of echocardiography can evaluate all the more accurately the size of PDA and play an important role in guiding transcatheter occlusion of PDA.