Objective To observe the value of global and contextual dual attention U-Net model for segmenting thoracic and lumbar vertebrae in spinal sagittal X-ray images.Methods Totally 600 spinal sagittal X-ray images of 600 patients with adolescent idiopathic scoliosis were retrospectively enrolled.The images were preprocessed,and T4-T12 and L1-L5 were manually annotated as reference standards.The global attention refinement(GAR)module and attention-based atrous spatial pyramid pooling(A-ASPP)module were added to U-Net model,fivefold cross validation method was used for training and validation,and its performance for segmenting sagittal X-ray images was analyzed,and compared with pyramid scene parsing network(PSPNet),visual geometry group(VGG)-UNet and DeepLabv3+.Results The precision,sensitivity and Dice similarity coefficient of global and contextual dual attention U-Net model for segmenting thoracic and lumbar vertebrae in spinal sagittal X-ray images was 90.58％,89.51％,and 90.20％,respectively,which were superior to PSPNet,VGG-UNet and DeepLabv3+.The loss function and mean intersection over union curves showed that it converged quickly and had good generalization ability.Conclusion The global and contextual dual attention U-Net model could effectively segment thoracic and lumbar vertebrae in spinal sagittal X-ray images.

OBJECTIVE To get the current situation of healthcare associated infection(HAI)and implement targe-ted management through analyzing the trends of HAI incidence rate,the distribution of clinical departments,the sites of HAI and the composition of pathogens in a children's hospital in a five-year period.METHODS Data on HAI cases were collected from all inpatients in Children's Hospital of Soochow University from 2019 to 2023 through the real-time monitoring system of XINGLIN Healthcare acquired Infection Surveillance;Cochran-Armit-age test was used to check for the significant changes of distribution of HAI cases.RESULTS A total of 383,376 hospitalized patients were monitored from 2019 to 2023,of which HAI occurred on 6670 cases and 7209 case-times with an incidence rate of 1.74%and an incidence case rate of 1.88%.The top five departments of HAI inci-dence rates were cardiac,neonatal,surgical and pediatric intensive care unit and department of hematology.HAI mainly occurred in blood and alimentary system,upper and lower respiratory tract.A total of 2668 strains of path-ogenic bacteria were isolated,of which 1346 strains were gram-negative bacteria,1140 strains were gram-positive bacteria and 182 strains were fungi.The top three gram-negative bacteria were Klebsiella pneumoniae,Escherich-ia coli and Pseudomonas aeruginosa;the top three gram-negative pathogens were Streptococcus,Staphylococcus aureus and Staphylococcus epidermidis;and the top three fungi were Candida albicans,Candida parapsilosis and Candida tropicalis.CONCLUSIONS The HAI incidence rate of this hospital steadily declines in the past five years,however the same changes are not observed in the departments with high incidence of HAI.Attention should be paid to the raising bloodstream infections and detection rate of S.epidermidis.

OBJECTIVE To explore the effect of hydrogen peroxide disinfectant on terminal disinfection in wards of medical institutions.METHODS The surfaces of highly frequent contact objects of the wards of the First Affilia-ted Hospital of Nanchang University from which the public health center patients were discharged between Apr.2024 and Jun.2024 were respectively disinfected with 0.5％(low)and 5％(high)concentrations of hydrogen peroxide disinfecting wipes,totally 180 samples were randomly collected before and after the disinfection,and the pathogens were detected.The air of the wards from which the public health center patients were discharged be-tween Jul.2024 and Aug.2024 were disinfected with hydrogen peroxide dry mist disinfection device,and 90 sam-ples were respectively collected before and after the disinfection.Geobacillus stearothermophilus was used as the biological indicator and placed at various points within the air-disinfected wards to evaluate the disinfection level.The environmental sampling results and distribution of bacteria were observed and compared.RESULTS The qualified rates of disinfection of the object surfaces were 95.56％(86/90)and 98.89％(89/90)respectively for the low and high concentratioins of hydrogen peroxide disinfecting wipes,and there was no significant difference in the disinfection effect.Totally 120 strains of pathogens were isolated from unqualified samples before the disinfection,among which gram-negative bacteria(69.17％)were dominant,and the isolation rate of multidrug-resistant or-ganisms was 22.50％(27/120);only 1 strain of carbapenem-resistant Acinetobacter baumannii was isolated after the disinfection.The qualified rate of disinfection of air in the wards was 96.00％by 7.5％hydrogen peroxide dry mist disinfection device,the average bacterial colony counts in the air were 2 CFU/(5 min·vsl)after the dis-infection,and the killing rate of Geobacillus stearothermophilus was 100.00％by the air disinfection.CONCLUSION The hydrogen peroxide disinfectant can meet the requirement for terminal disinfection of the wards of the medical institutions,and it is portable and highly efficient.

Objective To observe the repair effect and mechanism of Danhuang Powder-containing serum on high glucose-induced vascular endothelial cell injury.Methods Danhuang Powder-containing serum was prepared.Human umbilical vein endothelial cells(HUVECs)were cultured to be divided into control group,recombinant human epidermal growth factor(called"growth factor"for short)group,Danhuang Powder group,high glucose group,high glucose+growth factor group,and high glucose+Danhuang Powder group.After corresponding intervention in each group for 48 hours,the cell ultrastructure and autophagy were observed under transmission electron microscope,apoptosis was detected by flow cytometry,and the protein expression levels of vascular endothelial growth factor(VEGF),epidermal growth factor(EGF)and basic fibroblast growth factor(bFGF)in the cells were detected by Western Blot.Results(1)The intra-mitochondrial ridges in the control group were clearly visible,autophagosomes and autolysosomes were fewer;mitochondria in the high glucose group were swollen and irregular,and appeared vacuolated;and the more typical autophagy-like structures were seen in the high glucose+Danhuang Powder group.(2)Compared with the high glucose group and high glucose+growth factor group,the apoptosis rate of cells in the high glucose+Danhuang Powder group was significantly decreased(P<0.05).(3)Compared with the high glucose group and the high glucose+growth factor group,the protein expression levels of VEGF,EGF and bFGF in the cells of the high glucose+Danhuang Powder group were significantly increased(P<0.05).Conclusion Danhuang Powder-containing serum can reduce the high glucose-induced damage in HUVEC cells,and its mechanism may be related to the activation of mitochondrial autophagy,and the inhibition of apoptosis,as well as the up-regulation of the expression of VEGF,EGF and bFGF.

Gyrovirus galga1(GyVg1)and gyrovirus homsa1(GyH1)are two newly discovered cir-coviruses that can cause symptoms related to transmissible viral proventriculitis of chickens.These viruses have been reported in various regions worldwide.This research aims to establish a duplex real-time PCR assay capable of identifying and detecting GyVg1 and GyH1.Specific primers and probes were designed based on the conserved regions of GyVg1 and GyH1 respectively using all genome sequence data currently available in GenBank.After optimizing reaction conditions,the du-plex real-time PCR detection method was established and further validated by comparing it with a conventional PCR assay and sequencing results from an analysis of 256 clinical samples collected in 2023 across eight regions of Nanning,Guangxi.The results showed that GyVg1 and GyH1 could be identified in 1 h by the duplex real-time PCR assay and two pairs of primer probes can amplify effectively but there is no any cross reaction with other pathogens.Besides,the detection limit was determined to be 7.5 copies/μL.The correlation coefficient of standard curves exceeded 0.99,and CV for intra-and inter-assay was less than 0.45％.Based on clinical performance,when the quanti-ty of template was greater than or equal to 100 copies,the agreements between the duplex real-time PCR assay and the conventional PCR assay were 94.3％(GyVg1)and 100％(GyH1).In con-clusion,the newly developed duplex real-time PCR assays exhibited good specificity,sensitivity and repeatability,which could contribute to the rapid detection and differentiation of GyVg1 and GyH1.

In order to meet the demand of the high-end medical market,some public hospitals have explored the establishment of specialized diagnosis and treatment centers,providing high-end customized medical services at special registration prices.The establishment of the International Medical Center is an effective supplement to public welfare healthcare and an important measure for public hospitals to innovate and enhance themselves under the concept of value based healthcare.It conducts pioneering research and exploration on the cost-benefit accounting of international medical centers in public hospitals,and compares it with the accounting situation of conventional departments.By analyzing and calculating cost-effectiveness,medical indicators,and DRG data,the key points and difficulties of lean operation in international medical centers are explored.Innovative methods and ideas for platform fine accounting are proposed,which have guiding significance for its development direction.

Uterine arteriovenous fistula (UAVF), a relatively rare vascular anomaly, may lead to life-threatening hemorrhage and poses diagnostic and management challenges for primary hospitals during initial encounters. This article reports four cases of UAVF treated with Drospirenone and ethinyl estradiol tablets at Department of Gynaecology, Zhuji Maternal and Child Health Hospital between 2023 and 2024. Combined with literature review, we systematically analyzed the etiological mechanisms, clinical characteristics, and diagnostic-therapeutic strategies of this condition, with particular focus on evaluating the efficacy and safety of conservative pharmacological management. By summarizing case features and individualized treatment protocols, this study aims to provide clinical references for early identification, accurate diagnosis, and rational intervention of UAVF, thereby reducing risks of massive hemorrhage and long-term complications while improving patient prognosis.

To establish a double fluorescent RT-LAMP that can distinguish between chicken astro-virus(CAstV)and avian nephritis virus(ANV),two sets of specific primers and probes labeled with fluorescent groups were designed by comparing the conserved sequences of CAstV ORF1b gene and ANV ORF1b gene downloaded from GenBank.The CAstV probe was labeled with CY3 fluorophore at the 3'end and the quencher BHQ2 at the 5'end.The ANV probe was labeled with CY3 fluorophore at the 3'end and the quencher BHQ2 at the 5'end.The reaction system of the method was optimized,and specificity,repeatability,interference,sensitivity,and clinical sample detection were performed.The results were compared with RT-qPCR and RT-PCR to verify the ef-fectiveness of the method.The experimental results showed that the established double fluorescence RT-LAMP method could complete the reaction within 60 min,and the optimal reac-tion temperature was 65 ℃.This method only detects ANV and CAstV,with no cross-reactivity to other common avian pathogens.The minimum detection limit of CAstV was 1.4 ×10 2 copies/μL,and the minimum detection limit of ANV was 1.5×10 2 copies/μL.The interference and reproduc-ibility tests were good.Compared with RT-qPCR,the coincidence rates of CAstV and ANV were 97.97％and 98.85％,respectively.In conclusion,the double fluorescence RT-LAMP method estab-lished in this study has the characteristics of rapidity,accuracy,good specificity,high sensitivity and good reproducibility,which is suitable for clinical diagnosis and provides technical support for the epidemiological investigation of CAstV and ANV.

Objective To explore the distribution characteristics and influencing factors of nasal colonized bacteria of healthcare workers(HCWs)in pediatric intensive care unit(PICU).Methods A cross-sectional study was con-ducted.Nasal swab specimens from 104 HCWs in the PICU of a hospital were collected for bacterial culture and an-timicrobial susceptibility testing.According to the identification and antimicrobial susceptibility testing results of strains,distribution characteristics of colonized bacteria was analyzed.Basic information of studied subjects were collected through questionnaire survey,and risk factors for colonized bacterial infection were conducted using logis-tic regression analysis.Results Among 104 specimens,colonized bacteria were detected from 66 specimens,with an overall detection rate of 63.46％.Gram-positive bacteria was mainly Staphylococcus aureus,with a detection rate of 34.62％(n=36),out of which methicillin-resistant Staphylococcus aureus(MRSA)accounted for 2.88％(n=3).Gram-negative bacteria was mainly Klebsiella spp.,with a detection rate of 21.15％(n=22).Multiva-riate logistic regression analysis showed that HCWs with junior professional titles(OR=11.400,95％CI:2.329-55.801,P=0.003)was an independent risk factor for Staphylococcus aureus colonization,and male(OR=4.260,95％CI:1.160-15.653,P=0.029)was an independent risk factor for Klebsiella spp.colonization.Conclusion Nasal cavity of HCWs in PICU has a high detection rate of colonized bacteria,with Staphylococcus aureus and Klebsiella spp.being the major colonized bacteria.

Uterine arteriovenous fistula (UAVF), a relatively rare vascular anomaly, may lead to life-threatening hemorrhage and poses diagnostic and management challenges for primary hospitals during initial encounters. This article reports four cases of UAVF treated with Drospirenone and ethinyl estradiol tablets at Department of Gynaecology, Zhuji Maternal and Child Health Hospital between 2023 and 2024. Combined with literature review, we systematically analyzed the etiological mechanisms, clinical characteristics, and diagnostic-therapeutic strategies of this condition, with particular focus on evaluating the efficacy and safety of conservative pharmacological management. By summarizing case features and individualized treatment protocols, this study aims to provide clinical references for early identification, accurate diagnosis, and rational intervention of UAVF, thereby reducing risks of massive hemorrhage and long-term complications while improving patient prognosis.