ObjectiveTo conduct an epidemiological investigation, isolate and identify the pathogenic bacteria, and perform whole-genome sequencing (WGS) analysis of a food poisoning outbreak in Suzhou High-tech Zone, so as to provide references for the prevention and management of similar incidents. MethodsAn epidemiological investigation was carried out on affected individuals and restaurant staff. Multi-pathogen screening was performed on rectal swab samples from affected cases and restaurant staff, as well as on environmental swab samples from food preparation areas and retained food samples. WGS was performed on the pathogens isolated from the samples. ResultsA total of 15 cases were identified through hospital visit record reviews and on-site inquiries. Of the 15 case samples, 14 tested positive for Staphylococcus aureus (SA). In addition, 3 out of 15 staff samples and 6 out of 34 retained food samples tested positive for SA. WGS results revealed that the 6 food-derived isolates and 13 case-derived isolates shared the same sequence type (ST), Staphylococcal Protein A (SPA) type, and enterotoxin gene profile, with whole-genome single nucleotide polymorphism (wgSNP) differences of ≤5. Two novel SA sequence types: ST9159 and ST9161, were also identified in this study. ConclusionThis food poisoning outbreak is caused by contamination food with SA harbouring the seb and sec enterotoxin genes. The primary causes of contamination and cross-contamination included improper food handling practices, the use of the same utensils for raw and cooked foods, and extended storage of certain dishes at room temperature. Strengthening sanitary supervision in food handling facilities is crucial for reducing the occurrence of similar incidents.

Scoliosis is characterized by one or several segments of the spine bending sideways, accompanied by vertebral rotation and sagittal imbalance with complex etiology. Scoliosis can be caused by congenital vertebral abnormalities, asymmetry of the paraspinal muscles due to neurological lesions, and malnutrition or metabolic disorders of bone tissue. Growth hormone is a peptide hormone that plays a key role in promoting human growth and development, especially in bone growth. When the secretion of growth hormone in children or adolescents in the rapid growth stage is insufficient, it may lead to the occurrence of idiopathic short stature (ISS) and growth hormone deficiency (GHD). In clinic, ISS and GHD are mainly treated by recombinant human growth hormone (rhGH). According to some early clinical reports, in the process of rhGH treatment, many patients occur scoliosis or the original scoliosis progression is aggravated. Therefore, many scholars conclude that rhGH treatment of ISS or GHD will lead to the occurrence or development of scoliosis. However, with the increase of clinical statistics and the further progress of research, many scholars found that rhGH treatment of ISS or GHD will only increase the Cobb angle of patients with scoliosis, but will not lead to the occurrence of scoliosis, that is, rhGH treatment of ISS or GHD will not increase the prevalence of scoliosis. At present, whether rhGH treatment of ISS and GHD can lead to scoliosis and aggravation of scoliosis remains controversial. Therefore, this paper summarizes and analyzes the correlation research on the risk of scoliosis complications in children treated with rhGH, and concludes that age, gender, body mass index, and growth potential are risk factors for the development or progression of scoliosis during treatment, and discusses the balance of advantages and disadvantages of using rhGH for ISS or GHD to provide a direction for future clinical guidance.

Objective To explore the relationship between the distribution characteristics and the habitat factors of the invasive B. straminea in South China. Methods From October 2016 to August 2017, the breeding condition and habitat factors of B. straminea were investigated in the rivers of Shenzhen and its adjacent areas in the dry season, normal season and wet reason. The generalized additive model (GAM) was used to study the main habitat factors affecting the distribution density of B. straminea. Results The distribution characteristics of B. straminea showed obvious aggregation and unevenness in space. In terms of time, the density of snails was the highest in the dry season, followed by the normal water season and the least in the wet season. The GAM model analysis showed that the main habitat factors affecting the distribution density of B. straminea were water depth, water temperature, flow velocity, dissolved oxygen, and total phosphorus. When the flow velocity and water temperature were 0.25 m / s and 26 °C, respectively, the largest distribution density of snails might appear. The distribution density of B. straminea was positively correlated with dissolved oxygen and total phosphorus. Conclusion B. straminea is suitable to live in the water environment with poor water quality. In the future, the monitoring should be strengthened to provide reference for the prevention and control of the spread of the snails.

Objective:To investigate the clinical features and prognosis of acute necrotizing encephalopathy (ANE) in children.Methods:The clinical data and follow-up information of 41 pediatric patients with ANE treated in Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology from January 2014 to September 2019 were retrospectively reviewed.Results:The 41 patients included 23 males and 18 females with the onset age of (4.4±3.2) years.The main prodromal symptoms were gastrointestinal (20/41 cases, 48.8%) and respiratory infections (19/41 cases, 46.3%). Acute encephalopathy progressed rapidly following the prodromal infection [29 cases (70.7%) ≤2 days], and patients had clinical manifestations of coma (32/41 cases, 78.0%), convulsion (32/41 cases, 78.0%), multiple organ dysfunction (27/41 cases, 65.9%), shock and disseminated intravascular coagulation were rarely occured, and 28 cases (68.3%) were admitted to intensive care unit for treatment.Brain magnetic resonance imaging (MRI) showed lesion involving thalamus (41/41 cases, 100.0%), periventricular white matter (34/41 cases, 82.9%), brainstem (31/41 cases, 75.6%), basal ganglia (26/41 cases, 63.4%), cerebral cortex and subcortex (20/41 cases, 48.8%) and cerebellum (18/41 cases, 43.9%). The common presentations on the apparent diffusion coefficient mapping of brain MRI were " tricolor pattern" or " bicolor pattern" of the thalamus.During follow-up (≥ 6 months), MRI showed that hemorrhage, cystic degeneration and atrophy changed dynamically with the progression of ANE.All cases were treated with glucocorticoids, 38 cases(92.7%) with intravenous immune globulin.Seven cases (17.1%) were died and the 34 survivors had different degrees of neurological dysfunction.Conclusions:ANE in children is a distinctive type of clinicoradiologic syndrome with rapid progression and various presentations.Brain MRI has typical imaging characteristics and dynamically indicates the progression of this disease.The treatment options are still limited, the prognosis is poor and the survivors are often with neurological dysfunction.

Objective To study the dynamic diffusion characteristics of Biomphalaria straminea in Shenzhen, Dongguan and Huizhou of Southern China. Methods B. straminea was monitored at 25 investigation points along 10 river channels in Shenzhen, Dongguan and Huizhou by salvaging method. The diffusion characteristics of snails along with water in the Guihua New Village section of the Guanlan River and the Dawei Village section of the Longgang River were analyzed by GPS location drift test. In addition, the influence of flooding on the diffusion of B. straminea in the Kuichong River both before and after Typhoon ^"Shanzhu^" was analyzed by monitoring the hydrology and distribution of snails. Results In March and October from 2016 to 2018, a total of 1 176 kg of floating objects were salvaged in rivers in Shenzhen, Dongguan and Huizhou. Scattered B. straminea were found on water hyacinths. Drift test of floats with GPS showed that the average drift speed of GPS floating objects was close to the river surface velocity. Affected by river current and wind direction, the GPS floats quickly drifted to the river bank and stopped in the stagnant area due to the blockade of water plants, stone and the bending of the shoreline. The drift distance of each time was between 136 - 715m. The test results of salvaged floating objects found that the loss rates of B. straminea were 46.70% - 60.00% and 22.10% - 30.80%, in the Guihua New Village section of the Guanlan River and the Dawei Village section of the Longgang River, respectively, which were significantly affected by the floating weight, river velocity and drifting distance. The analysis of the hydrology and distribution of B. straminea in the Kuichong River both before and after Typhoon ^"Shanzhu^" showed that the density of B. straminea in the river was significantly reduced by the flood. Conclusion B. straminea is mainly transported as suspended matter in water body, and flooding was an important factor in its long-distance diffusion.

Objective:To evaluate the clinical characteristics and prognosis of gallbladder cancer (GBC) patients in China.Methods:This retrospective multicenter cohort study enrolled 3 528 consecutive GBC patients diagnosed between January 2010 to December 2017 in 15 hospitals from 10 provinces. There were 1 345 (38.12%) males and 2 183 (61.88%) females.The age of diagnosis was (63.7±10.8) years old (range: 26 to 99 years old) .There were 213 patients (6.04%) in stage 0 to Ⅰ, whereas 1 059 (30.02%) in stage Ⅱ to Ⅲ, 1 874 (53.12%) in stage Ⅳ, and 382 (10.83%) unavailable. Surgery was performed on 2 255 patients (63.92%) . Three hundred and thirty-six patients received chemotherapy or radiotherapy (9.52%; of which 172 were palliative); 1 101 (31.21%) received only supportive treatment.The patient source, treatment and surgery, pathology, concomitant gallstone, and prognosis were analyzed.Results:Among the 3 528 GBC patients, 959 (27.18%) were from East China, 603 (17.09%) from East-North China, 1 533 (43.45%) from Central China, and 433(12.27%) from West China. Among the 1 578 resectable tumor, 665 (42.14%) underwent radical surgery, 913 (57.86%) underwent surgery that failed to follow the guidelines.Eight hundred and ninety-one (56.46%) patients were diagnosed before surgery, 254 (16.10%) during surgery, and 381 (24.14%) after surgery (time point of diagnosis couldn′t be determined in 52 patients) .Among the 1 578 patients with resectable tumor, 759 (48.10%) had concomitant gallstone.Among the 665 patients underwent radical surgery, 69 (10.4%) showed positive resection margin, 510 (76.7%) showed negative resection margin, and 86 (12.9%) unreported margin status.The 5-year overall survival rate (5yOS) for the 3 528-patient cohort was 23.0%.The 5yOS for patients with resectable tumor was 39.6%, for patients with stage ⅣB tumor without surgery was 5.4%, and for patients with stage ⅣB tumor underwent palliative surgery was 4.7%.Conclusions:More than half GBC patients in China are diagnosed in stage Ⅳ.Curative intent surgery is valuable in improving prognosis of resectable GBC.The treatment of GBC needs further standardization.Effective comprehensive treatment for GBC is in urgent need.

Objective:To evaluate the clinical characteristics and prognosis of gallbladder cancer (GBC) patients in China.Methods:This retrospective multicenter cohort study enrolled 3 528 consecutive GBC patients diagnosed between January 2010 to December 2017 in 15 hospitals from 10 provinces. There were 1 345 (38.12%) males and 2 183 (61.88%) females.The age of diagnosis was (63.7±10.8) years old (range: 26 to 99 years old) .There were 213 patients (6.04%) in stage 0 to Ⅰ, whereas 1 059 (30.02%) in stage Ⅱ to Ⅲ, 1 874 (53.12%) in stage Ⅳ, and 382 (10.83%) unavailable. Surgery was performed on 2 255 patients (63.92%) . Three hundred and thirty-six patients received chemotherapy or radiotherapy (9.52%; of which 172 were palliative); 1 101 (31.21%) received only supportive treatment.The patient source, treatment and surgery, pathology, concomitant gallstone, and prognosis were analyzed.Results:Among the 3 528 GBC patients, 959 (27.18%) were from East China, 603 (17.09%) from East-North China, 1 533 (43.45%) from Central China, and 433(12.27%) from West China. Among the 1 578 resectable tumor, 665 (42.14%) underwent radical surgery, 913 (57.86%) underwent surgery that failed to follow the guidelines.Eight hundred and ninety-one (56.46%) patients were diagnosed before surgery, 254 (16.10%) during surgery, and 381 (24.14%) after surgery (time point of diagnosis couldn′t be determined in 52 patients) .Among the 1 578 patients with resectable tumor, 759 (48.10%) had concomitant gallstone.Among the 665 patients underwent radical surgery, 69 (10.4%) showed positive resection margin, 510 (76.7%) showed negative resection margin, and 86 (12.9%) unreported margin status.The 5-year overall survival rate (5yOS) for the 3 528-patient cohort was 23.0%.The 5yOS for patients with resectable tumor was 39.6%, for patients with stage ⅣB tumor without surgery was 5.4%, and for patients with stage ⅣB tumor underwent palliative surgery was 4.7%.Conclusions:More than half GBC patients in China are diagnosed in stage Ⅳ.Curative intent surgery is valuable in improving prognosis of resectable GBC.The treatment of GBC needs further standardization.Effective comprehensive treatment for GBC is in urgent need.

Objective: To evaluate the success rate during ultrasound-guided percutaneous nephrolithotomy (PCNL) and analyze the reasons of puncture failure. Methods: A retrospective analysis was performed based on the data of 58 patients who underwent ultrasound-guided PCNL by 4 experienced urologists(10 years' experience of PCNL and more than 80 cases per year)in our center from August 2018 to November 2018. Of all the 58 patients, there were 36 males and 22 females (aged from 22 to 73 years) with the mean age of 51 years. The calculi ranged from 9 mm to 93 mm, with the average of 26.5 mm. The separation of renal collecting system ranged from 5 mm to 30 mm, with the average of 15.1 mm. All of the 58 patients underwent one-stage PCNL and the numbers of punctures, the numbers of percutaneous tubes and the reasons for failure were recorded. Results: All percutaneous tubes and surgeries were established and done successfully. Of all the 118 punctures, 74 punctures succeeded by detecting the urine and 68 surgery tracts were established (6 punctures failed because of the dilation). The total puncture success rate was 62.7%(74/118). Of the total 74 successful punctures, 56.8%(42/74)succeeded at the first puncture, 28.4%(21/74)succeeded at the second puncture and 14.9%(11/74)succeeded at least after three punctures. The success puncture rate of the 4 urologists were 59.2%(29/49), 64.1%(25/39), 66.7%(16/24), 66.7%(4/6)respectively, and there were no statistical differences between the puncture success rates of the urologists (P=0.679). Each channel needed 1.7 punctures on average. Fouty-four punctures failed without detecting the urine, including 20 failed punctures because of the puncture tract deviation, 17 punctures without seeing the urine after the core needle being removed, 7 punctures no display on the ultrasound imagine. There were 33 punctures to be tubeless while other 35 indwelling the nephrostomy tubes. Five nephrostomy tubes' position were different with the preoperationally predicted position which means the discrepancy rate was 14.3%(5/35). One patient had complications and classified as Grade II or above on the modified Clavien Grading System of aerothorax. Conclusions The puncture success rate during ultrasound-guided PCNL is not satisfied. The main reasons of puncture failure are the deviation of puncture tract, unclear imaging of puncture tract and other unclear reasons( puncture needle went too deep or superficially or tip of the needle embedded into the stone).

JCI standard is the most professional and authoritative certification standard of medical quality and safety system in the world. HRP information system is a systematic hospital resource management platform which integrates the existing hospital information resources and establishes a set of unified, efficient, interconnected and information sharing operation and management of the hospital. In order to meet the requirements of closed-loop management of implantable medical devices in the JCI standard, our hospital has established a set of standards which based on the HRP system platform, including access permission, purchase application, entering and leaving the warehouse, bookkeeping charge, cost accounting and postoperative traceability of implanted medical device management system. HRP system improves the management level of implantable medical devices, and realizes the closed-loop management of the whole process of implantable medical devices.
Hospitals ; Humans ; Information Dissemination ; methods ; Management Information Systems ; standards ; Prostheses and Implants

The gas chromatography method was developed for the determination of ethylene glycol, diethylene glycol and triethylene glycol in poloxamer 188 to provide scientific basis for the quality control. The samples was separated on column VF-17ms(30 m×0. 53 mm, 1. 0 μm)with temperature programming, inlet temperature was 270 °C, detector temperature was 290 °C and the split ratio was 10 ∶1. The method showed great linearity over the range of 6-15 μg/mL(r≥0. 999). The injection precision(n=8)of the three residual impurities were 3. 3%, 3. 0%, 2. 3% and the average recoveries were 99. 05%(RSD=2. 9%, n=9), 102. 20%(RSD=4. 0%, n=9), 101. 91%(RSD=3. 1%, n=9), respectively. The analytical method is specific, accurate and sensitive, which is suitable for the determination of ethylene glycol, diethylene glycol and triethylene glycol in poloxamer 188, providing reference and guidance for the production and quality control of poloxamer 188.