Objective:To evaluate the disinfection effect of high-energy pulse ultraviolet disinfection equipment in medical institution settings.Methods:The disinfection effect was evaluated through field tests and laboratory tests. Among them, 135 high-frequency contact points were selected from nine departments in the field test. Samples were collected before and after disinfection, and the disinfection effects of 75% alcohol wipes wiping disinfection, high-energy pulse ultraviolet disinfection robot disinfection and high-energy pulse ultraviolet handheld disinfection instrument were compared. In the laboratory test, 30 infected areas of the simulated test table were exposed to vertical ultraviolet irradiation and the bacterial-killing rate before and after disinfection was calculated.Results:In the field test, the bacteria-killing rates of 75% alcohol wipes, high-energy pulse ultraviolet disinfection robot and high-energy pulse ultraviolet handheld disinfection instrument were 94.99%, 91.53% and 95.94%, respectively, and the difference was statistically significant. The disinfection effect of the high-energy pulse ultraviolet handheld disinfection instrument was better than that of the high-energy pulse ultraviolet disinfection robot ( P values <0.05). In the laboratory test, the killing log value of Staphylococcus aureus and Escherichia coli on the carrier were both greater than 3.00. In the simulated field test, the killing log value of Staphylococcus aureus on the surface samples were 4.99. Conclusion:Both the high-energy pulse ultraviolet handheld disinfection instrument and the high-energy pulse ultraviolet disinfection robot have good disinfection effects, which are similar to the disinfection effects of conventional 75% alcohol wipes.

Objective:To evaluate the disinfection effect of high-energy pulse ultraviolet disinfection equipment in medical institution settings.Methods:The disinfection effect was evaluated through field tests and laboratory tests. Among them, 135 high-frequency contact points were selected from nine departments in the field test. Samples were collected before and after disinfection, and the disinfection effects of 75% alcohol wipes wiping disinfection, high-energy pulse ultraviolet disinfection robot disinfection and high-energy pulse ultraviolet handheld disinfection instrument were compared. In the laboratory test, 30 infected areas of the simulated test table were exposed to vertical ultraviolet irradiation and the bacterial-killing rate before and after disinfection was calculated.Results:In the field test, the bacteria-killing rates of 75% alcohol wipes, high-energy pulse ultraviolet disinfection robot and high-energy pulse ultraviolet handheld disinfection instrument were 94.99%, 91.53% and 95.94%, respectively, and the difference was statistically significant. The disinfection effect of the high-energy pulse ultraviolet handheld disinfection instrument was better than that of the high-energy pulse ultraviolet disinfection robot ( P values <0.05). In the laboratory test, the killing log value of Staphylococcus aureus and Escherichia coli on the carrier were both greater than 3.00. In the simulated field test, the killing log value of Staphylococcus aureus on the surface samples were 4.99. Conclusion:Both the high-energy pulse ultraviolet handheld disinfection instrument and the high-energy pulse ultraviolet disinfection robot have good disinfection effects, which are similar to the disinfection effects of conventional 75% alcohol wipes.

Radiotherapy is one of the main treatment methods for malignant tumors, which can cause the radiation damage to normal tissues. Radiation-induced skin injury (RISI) is one of the main adverse reactions caused by radiotherapy. The main clinical manifestations of RISI are dermatitis, ulcer, erosion and necrosis, which seriously affect the quality of life and treatment effect of tumor radiotherapy patients, and even affect the overall survival of patients. The pathological mechanism of RISI is still unclear. Some studies have shown that inflammation and oxidative stress are the main causes of RISI. RISI can be divided into acute and chronic RISI according to the different onset time, and different treatment strategies can be formulated according to the severity of the injury. In this article, clinical manifestations, classification, pathogenesis, prevention and treatment of RISI are comprehensively summarized.

Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.

Objective To search for a treatment approach for scalp avulsion injury based on the clinical experiences and review of literature.Methods Twenty-six consecutive scalp avulsion cases were involved in the study:15 cases were complete scalp avulsion (5 including forehead skin) and 11 cases were partial scalp avulsion.Cranial bones exposure occurred in 16 cases,11 of which had a size over 4 × 4 cm2.The treatment methods were various:11 cases with microsurgical replantation,9 cases with skin grafting,4 cases with secondary skin grafting followed by multiple drilling of the calvarium,1 case with local flap,and 1 case with free flap.According to the clinical cases and literature reviews,authors tried to search for an optimal protocol.Results Patients with microsurgical replantation achieved the best recovery including hair growth.In case of not qualified or fail to microsurgical replantation,skin graft could be considered as an alterative step,whereas the result of it was no hair growth and usually scar healing.In summary,14 different clinical conditions followed with 10 surgical techniques were concluded in a route chart.Conclusions To achieve the optimal outcomes of scalp avulsion injury,proper techniques should be chosen according to the treatment protocols.

Objective To compare the performance of Lung Imaging Reporting and Date System (Lung-RADS)with National Lung Screening Trail (NLST)in pulmonary nodules screening.Methods 1 5 3 patients with pulmonary nodules were analyzed retro-spectively,including,baseline screening and after baseline screening.We compared the sensitivity,false-positive result rate,positive predictive value,and negative predictive value in two methods of screening.Results In baseline screening of all patients with pulmo-nary nodules,the sensitivity,false positive rate and positive predictive value and negative predictive value of Lung-RADS and NLST were 83.9%,13.2%,6.5%,99.7% and 92.5%,26.9%,3.8%,99.8% respectively.In after baseline screening,the sensitivity, false positive rate and positive predictive value and negative predictive value were 79.6%,5.5%,11.5%,99.8% and 93.5%,22.8%, 3.5%,99.9% respectively.Conclusion Lung-RADS classification can reduce the false positive rate in screening of pulmonary nod-ules,which reduced the screening of lower risk nodules.

Objective To investigate the role of transmembrane protein C0-029 in epithelial mesenchymal transition (EMT) induced by tumor necrosis factor alpha (TNFα) of intrahepatic cholangiocarcinoma (ICC) cells.Methods RT-PCR and Western blot were conducted to detect the CO-029 expression in ICC cells and tissues.The effect of CO-029 silencing by lenti-virus on EMT induced by TNFα was investigated.Western blot and mass spectrometry after immunoprecipitation were used to confirm whether TNFαR1 can directly or indirectly bind with CO-029 to form complexes in ICC.Results Differential expression of CO-029 was observed in ICC cells and tissues.The expression of CO-029 was significantly reduced by lenti-viral interference in ICC cells,resulting in the failure of TNFα to induce EMT.TNFαR1 in ICC could directly or indirectly form complexes with CO-029.Conclusion CO-029 mediates TNFα/TNFαR1 induced EMT in ICC,which might play an important role in the invasion and metastasis.

Objective To investigate the expressions of tetraspanin CO-029 in intrahepatic cholangiocarcinoma (ICC) and to find out their clinical significance.Methods RT-PCR and western blot were used to detect the expressions of CO-029 in ICC and their matched para-tumorous tissues from 20 patients with ICC,as well as in the HCCC-9810 cell lines.The expressions of CO-029 were further detected via tissue microarray (TMA) in the pathological specimens of 40 patients with ICC.Correlations between the expressions of CO-029 and the clinicopathologic features and prognosis were analyzed.Results A high level of CO-029 was detected in the 20 patients with ICC and the HCCC-9810 cell lines via western blot and RTPCR.Moreover,the expression levels of CO-029 in the ICC tissues were higher than the matched para-tumorous tissues (P ＜ 0.05).TMA detection revealed the positive expression rate of CO-029 to be 65％ (26/40).The expression level of CO-029 was much higher in the early recurrence group (Time to recurrence,TTR ＜ 1 year) than the non-recurrence group (TTR≥ 1 year).On analysis,the correlations were significant between the expressions of CO-029 and tumor encapsulation,hilar lymph node metastasis,TNM stage and prognosis (P ＜0.05).Conclusions CO-029 was highly expressed in ICC.It had close correlations with recurrence,metastasis and prognosis of patients with ICC.

Objective To evaluate the effectiveness of web-based mental health services.Methods Web-based mental health services were established in our hospital to offer continuing medical education on mental health and psychological assessments.The access of clinicians to psychiatric knowledge and consultation from psychiatry department was evaluated.Results A total of 803 medical staff took the continuing medical education,and 643 passed the examination.Five hundred and twenty-eight online psychological assessments were completed.The qualification rate of psychiatric examination was 83.3％ vs.31.7％ in educated and non-educated clinicians (x2=32.77,P＜0.01).The common consultation from psychiatry department of the educated group involved anxiety,depression/mania and delirium,of which anxiety and medically unexplained symptoms were comparatively higher while delirium was lower than the non-educated group (x2 values were 4.80,4.59 and 5.16,respectively; all P＜0.05).More use of online psychological assessments was found in the educated group (33.8％ vs.7.6％) before asking for a consultation from psychiatry department (x2=30.04,P＜0.01).Conclusions Online mental health continuing education and psychological assessment could improve psychiatric knowledge and recognition of anxiety and depression in clinicians.

Objective To explore the curative effect between via Quadrant minimally invasive surgery and open surgery in the treatment of lumbar disc herniation (LDH) and the effective nursing method for complication.Methods One hundred and fifteen LDH patients including 79 males and 36 females from January 2011 to January 2012 were chosen and divided into the via Quadrant minimally invasive operation transforaminal lumbarinterbody fusion(TLIF) group (Mini-TLIF,n =53) and the open surgery TLIF group (Open-TLIF,n =62).The length of incision,operative blood loss,symptom improvement,postoperative drainage,the time of postoperative ambulation and hospitalization,the incidence of complications were analyzed and compared between two groups to further explore the effective nursing method.Results The length of incision,operative blood loss,postoperative drainage,the time of postoperative ambulation and hospitalization in the Mini-TLIF group were better than those in the Open-TLIF group,and the differences were statistically significant (t =16.91,57.72,56.55,11.20,12.46,respectively; P ＜ 0.01).The difference was found in the score of Visual Analogue Scale before and after treatment in each group (t =34.108,40.964,respectively; P ＜0.01),but no difference was found before and after treatment between two groups (P ＞ 0.05).The cases of deep vein thrombosis and wound hematoma were respectively 1,0 case in the Mini-TLIF group,and were 21,10 cases in the Open-TLIF group,and the differences were statistically significant (x2 =18.894,7.441,respectively; P ＜ 0.01).Conclusions Both mini-TLIF and open-TLIF can effectively improve the back and leg pain in LDH patients.However,mini-TLIF is lower or shorter than open-TLIF in the aspects of the length of incision,operative blood loss,postoperative drainage,the time of postoperative ambulation and hospitalization; and the LDH patients with mini-TLIF have less pain,the shorter time in bed,the faster recovery; and the mini-TLIF can not only reduce the incidence rate of postoperative complications,but also greatly reduce the burden of clinical nursing.