Objective: To investigate the hygienic status of the central air conditioner ventilation system in public places in urban areas of Ma'anshan City, Anhui Province, so as to provide insights into formulation of supervision and management interventions. Methods: A total of 15 public places with the central air conditioner ventilation system were randomly sampled from main urban areas in Ma'anshan City in 2022. Sampling and detection were performed following the standard GB/T 18204.5—2013 Examination methods for public places Part 5: Central air conditioning ventilation system, including total number of bacteria and total number of fungus on the inner surface of wind pipes, total number of bacteria and fungus, particulate matter (PM10) and β-hemolytic streptococci in the air supply system, and Legionella pneumophila in the cooling water, and the detection indicators were assessed following the WS 394—2012 Guideline for hygiene of the central air conditioner ventilation system in public places. The eligible rate of samples, the detection rate of L. pneumophila were analyzed. Results: A total of 368 samples were collected from 15 public places, and the qualified rate was 50.54%, no places had all eligible measurement indicators. The qualified rates of total bacteria and fungus numbers on the inner surface of wind pipes were 52.67% and 59.33%. The qualified rates of total bacterium number, total fungus number, PM10 and β-hemolytic streptococci were 12.00%, 28.00%, 90.00% and 96.00% in the air supply system. The qualified rates of samples in administrative workplaces, hotels, bathing places and malls (supermarkets) were 32.50%, 59.24%, 61.09% and 68.92%, the qualified rates of total bacteria on the inner surface of air ducts were 8.33%, 72.46%, 66.67% and 61.90%, and the qualified rates of total fungus numbers in air supply were 0, 21.70%, 33.30% and 71.40%, respectively, with statistical significance (P<0.05). A total of 18 cooling water samples were collected, and L. pneumophila was detected in three samples (16.67%). Conclusions Poor hygiene is seen in the central air conditioning ventilation systems in public places in main urban areas of Ma'anshan City. High attention needs to be paid to contamination of bacterium, fungus and L. pneumophila, and expansion of supervision coverage and improved supervision intensity are recommended.

【Objective】 To investigate the main causes of blood donor deferral in domestic blood center. 【Methods】 The causes of donor deferral were classified into 12 categories as previous medical history, drug use, alcohol consumption, menstrual period, underweight, abnormal blood pressure, abnormal body temperature, abnormal hemoglobin (Hb), lipemic blood, positive hepatitis B surface antigen (HBsAg), elevated alanine aminotransferase (ALT) and others according to the comparison indicators of Asia-Pacific Blood Network (APBN) and the national standard Blood Donor Health Examination Requirements. The relevant data of the top 3 causes of donor deferral, voluntarily reported by the members of Practice Comparison Working Group of China’s Mainland Blood Collection and Supply Institutions from 2014 to 2019, were collected and a histogram was generated. 【Results】 The median donor deferral rate of 20 domestic blood centers from 2014 to 2019 was 12.14%, with the lowest at 0.18% and highest at 32.32%, respectively. The top three causes for donor deferral were elevated ALT, abnormal Hb and abnormal blood pressure in year 2014, 2015, 2018 and 2019; elevated ALT, lipemic blood and abnormal blood pressure in 2016; elevated ALT, abnormal Hb, and lipemic blood in 2017. 【Conclusion】 The main causes of donor deferral were elevated ALT, abnormal Hb, abnormal blood pressure and lipemic blood.

Objective:To observe the clinical efficacy and side effects of injecting different doses of botulinum toxin type A (BTX-A) into children with spastic cerebral palsy (CP) and tiptoe deformity.Methods:A total of 107 children with tiptoe deformity resulting from CP were divided into group A ( n=35), group B ( n=36) and group C ( n=36) using a random number table. Group A received 3u/kg injections of BTX-A, group B received 4u/kg injections and group C received 5u/kg. The injections were guided by color Doppler ultrasound and followed by 4 courses of rehabilitation therapy. Before and 1, 3 and 6 months after the treatment, the modified Tardieu scale (MTS) was used to assess gastrocnemius spasms, while sections D and E of gross motor function scale 88 (GMFM-88) and the pediatric balance scale (PBS) were used to evaluate motor functioning and balance. Any side effects were also observed. Results:After the treatment, improvement was observed in all of the measurements, though there were no significant differences in the degree of improvement nor in the incidence of side effects among the three groups.Conclusions:There is no significant difference in clinical efficacy or side effects involved in using different doses of BTX-A to treat tiptoe deformity in children with spastic cerebral palsy. The recommended dosage is therefore 3u/kg.

The standardized residency training has become a necessary way to improve the overall professional quality of doctors. At present, a single teaching model can't meet the needs of the standardized residency training. This study explores the application of problem-based learning (PBL) combined with multidisciplinary treatment (MDT) model in the general surgery teaching of standardized residency training, so that the residents can use their theoretical knowledge to think deeply about the problems in the cases. By consulting the literature review, the cases are analyzed from multiple levels and angles, such as pathogenic causes, pathogenesis and clinical manifestations, then the clinic diagnosis and therapeutic schedule can be obtained. This kind of teaching model not only stimulates the group's more interest in learning, and improves the ability of autonomous learning, independent analysis, problem solving and language expression, but also significantly improves teaching satisfaction and has obvious teaching advantages.

Long-term intake of large amounts of ethanol leads to enterogenous endotoxemia. Reactive oxygen species, high concentrations of adenosine triphosphate and uric acid activate the pyroptosis system, which then cleaves the pore formation mechanism of gasdermin-D, leading to the death of liver cells, accompanied by the release of interleukin-1β, interleukin-18, and other inflammatory factors. This series of processes activates the immune system, mediates a cascade of inflammation, and promotes the development of alcoholic liver disease from steatosis to inflammation and fibrosis.

Objective To investigate the significance of using procalcitonin (PCT) combined with acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores to estimate the prognosis of elderly patients with sepsis. Methods One hundred and fourteen elderly patients with sepsis admitted into the Department of Intensive Care Unit (ICU) of 13th Division Xinjiang Production and Construction Corps Red Star Hospital from January 2011 to December 2017 were enrolled, general information of all patients [sex, age, body mass index (BMI), smoking, drinking alcohol, site of infection, underlying disease or complication, education level and marital status], vital signs (pulse, respiration frequency, pH value, body temperature, oxygenation index, diastolic blood pressure, systolic blood pressure), blood and biochemical indicators [blood sugar, high-density lipoprotein (HDL) and low-density lipoprotein (LDL)], D-dimer, PCT, C-reactive protein (CRP), APACHE Ⅱ, chronic health score (CHS) were recorded and survival situation of all patients after entering the study for 28 days. Univariate and multivariate analyses were used to analyze the prognostic factors of elderly patients with sepsis, and the receiver operating characteristic curve (ROC) was drawn to evaluate the diagnostic efficacy of the factors in sepsis. Results Within 28 days from admission to hospital, 64 patients (44.44%) died, 80 patients (55.56%) survived, and there were no significant differences in the sex, age, BMI, infected site, underlying disease or complication, education level, marital status, smoking, drinking alcohol, pulse, respiration frequency, pH, body temperature, oxygenation index, blood pressure, blood glucose, HDL, LDL and infection type in the comparisons between the survival and death groups (all P > 0.05). Compared with the survival group, the D-dimer, PCT, CRP, APACHE Ⅱ, mechanical ventilation ratio were higher in the death group [D-dimer (mg/L):3.6±1.1 vs. 3.2±1.2, PCT (mg/L): 15.4±3.5 vs. 4.1±1.4, CRP (ng/L): 637.0±8.9 vs. 596.0±9.6, APACHEⅡ:31.4±5.5 vs. 16.4±4.5, proportion of mechanical ventilation: 87.5% (56/64) vs. 56.2% (45/80), all P < 0.05];multivariate analyses showed that PCT, APACHEⅡ and proportion of mechanical ventilation were independent risk factors of the prognosis of sepsis [PCT: odds ratio (OR) = 4.126, 95% confidence interval (95%CI) = 2.045-6.115, P = 0.000; APACHEⅡ: OR = 2.935, 95%CI = 1.237-4.118, P = 0.001; mechanical ventilation: OR = 2.012, 95%CI =1.068-3.048, P = 0.034, all P < 0.05]. The PCT, APACHE Ⅱ and PCT combined with APACHEⅡ all can be used to diagnose the prognosis of senile sepsis, and the diagnostic value of PCT combined with APACHEⅡ was the largest [area under the ROC curve (AUC) = 0.946, 95%CI = 0.894-0.971, sensitivity = 86.7%, specificity = 90.8%, P = 0.000]. Conclusion PCT combined with APACHE Ⅱscore can be used to estimate the prognosis of elderly patients with sepsis.

Objective To explore the role of cerebrospinal fluid chimerism in central nervous relapse surveillance for patients of acute leukemia after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods The follow-up data were retrospectively collected and analyzed in 104 patients with acute leukemia after allo-HSCT.Comparisons were made between patients with complete chimerism and mixed chimerism in cerebrospinal fluid.The role of recipient DNA percentage and its changing trend in predicting central nervous relapse were also explored.Analysis was conducted for determining the risk factors of central nervous relapse.And the effectiveness of prophylaxis with intrathecal injection was also examined.Results The incidence of relapse was higher in patients with mixed chimerism (P＜0.001),high percentage of recipient DNA (P＜0.05) and higher mixed chimerism (P＜0.001).Hyperleukocytosis at an initial diagnosis was a risk factor of central nervous relapse.Whether or not intrathecal injection prophylaxis was applied showed no significant difference in relapsing rate.Conclusions Monitoring cerebrospinal fluid chimerism can effectively help predict central nervous relapse among patients of acute leukemia after allo-HSCT.Yet intrathecal injection prophylaxis failed to benefit recipients.

Objective To compare the effectiveness of cerebral palsy rehabilitation patterned on the children and youth version of the international classification of functioning,disability and health (ICF-CY) with traditional patterns.Methods Two children's rehabilitation wards were selected as the ICF-CY group and the control group.The children in the former group were evaluated using the ICF-CY and provided with individual rehabilitation plans according to their evaluation results,while those in the latter group were given traditional rehabilitation without any evaluation.Before and after 3 courses of treatment,both groups were assessed using the pediatric evaluation of disability inventory (PEDI) and the gross motor function measure (GMFM),and their use of assistant devices was assessed.Results After three courses of treatment the ICF-CY group's average PEDI score had improved significantly and was superior to that of the control group.Significant improvement was observed in the GMFM scores in both groups after the treatment,with no significant inter-group differences.Significantly more of the children in the ICF-CY group used the assistive devices (except the lower limb orthoses) compared to the control group.Conclusion Therapy based on the ICF-CY is obviously superior to traditional rehabilitation planning.

Objective To explore the effect of acupuncture plus neuromuscular electrical stimulation and cold stimulation on children with swallowing disorders caused by viral encephalitis.Methods A total of 322 chil dren with dysphagia subsequent to viral encephalitis were randomly divided into an acupuncture + cold stimulation group (group A,n=107),an electrical stimulation + cold stimulation group (group E,n=107) and an acupuncture + electric stimulation + cold stimulation group (group C,n=108) using a random number table.The treatments were applied in two courses each of 14 days with an interval of two days between the courses.Before and after the treatment,the total effectiveness rates and the incidence of aspiration pneumonia and malnutrition were ana lyzed.The children's swallowing function was evaluated using a standardized swallowing assessment (SSA),while the severity of dysphagia was assessed using dysphagia outcome and severity scale (DOSS) based on videofluorescopic imaging.Results There were no significant differences in any of the outcome measures before the treatment.Afterward the total effectiveness rate in group A was 76％,significantly higher than in group E (62％) but significantly lower than in group C (91％).There was significant improvement in the average SSA and DOSS scores of all 3 groups.Compared with group A,the average SSA score of group E was higher while the average DOSS score was lower.For group C the relationship was the opposite,with the average SSA score significantly higher and the average DOSS score significantly lower.After the treatment there were no significant differences between groups A and E in the incidence of aspiration pneumonia or malnutrition,but the incidence of both in group C was significantly lower than in groups A and E.Conclusion Acupuncture administered together with electrical and cold stimulation can significantly improve dysphagia and lower the incidence of aspiration pneumonia and malnutrition for children with viral encephalitis.

Objective: To evaluate the prognostic value of lymphocyte-to-monocyte ratio (LMR) in angioimmunoblastic T cell lymphoma (AITL). Methods: Data of 64 patients diagnosed as AITL at the First Affiliated Hospital of Nanjing Medical University between June 2009 and July 2017, were analyzed retrospectively. Receiver Operator Characteristic (ROC) curve was used to calculate the cutoff value of LMR to divide this cohort of patients into high and low LMR groups. Characteristics between groups were compared by Pearson Chi-square or Fisher exact tests. Kaplan-Meier method and Cox regression were performed to probe prognostic factors associated with progression-free survival (PFS) and overall survival (OS). Results: A total of 64 cases [39 cases male and 25 ones female with the median age of 63 (29-89) years old] were enrolled. The cutoff value of LMR was 3.07. Patients with low LMR showed inferior PFS (9 months vs 13 months, P=0.044) and OS (16 months vs not reached, P=0.014), respectively than those without low LMR during a median follow-up of 33 months (5 to 103 months). Multivariate analysis showed that low LMR was an independent prognostic factor associated with poor outcomes (HR=0.48, 95% CI 0.26-0.92 for PFS, P=0.027; HR=0.38, 95% CI 0.18-0.82 for OS, P=0.013, respectively). Subgroup analysis showed that patients with low LMR and under the situation of high score of Prognostic Index for peripheral T-cell lymphoma, Unspecified (PIT) (2-4) had shorter PFS and OS (P=0.013 and P=0.031, respectively). But in low score of PIT (0-1) group, low LMR seemed to play almost no effects on PFS and OS (P=0.949 and P=0.238, respectively). Conclusions The disease risk status of patients could be initially assessed according to PIT score and LMR level. Low LMR was demonstrated to be able to predict poor outcome in AITL.