ObjectiveTo understand the use of antibiotics in inpatients and the incidence and trend of hospital infections， to explore the implementation effect of comprehensive management measures， and to provide reference for hospitals to use antibiotics reasonably. MethodsBased on the hospital infection monitoring and management system， a retrospective analysis and comparison were conducted on the use of antibiotics， submission of microbial test samples， and incidence of hospital infections among inpatients in a tertiary hospital from 2012 to 2021. ResultsFrom 2012 to 2021， the use of antibiotics showed a downward trend， from 50.82% in 2012 to 41.29% in 2021. At the same time， the use rate of restricted and special antibiotics had also decreased， and the use rate of restricted and special antibiotics in patients without hospital infection was significantly lower than that in patients with hospital infection， and the microbial testing rate was also on the rise. The annual incidence rate of hospital infection was 0.69%‒1.92%， and the annual case-time prevalence rate was 0.79%‒2.17%. The annual average rate of the above two in 10 years was 1.18% and 1.34%， respectively. The results of the exponential smoothing model also showed that the utilization rate of antibiotics was decreasing and the incidence of nosocomial infection was stable. ConclusionLarge general hospitals took comprehensive management measures to strengthen the management of rational use of antibiotics， which led to a decline in the use rate of antibacterial drugs for inpatients and an increase in the rate of microbial examination. At the same time， the overall incidence of hospital infection was relatively stable， suggesting that the comprehensive management measures of antibacterial drugs in hospitals had achieved certain results. The current measures need to be optimized in the future to continuously improve the management level of rational use of antibacterial drugs.

New threats posed by the emerging circulating variants of SARS-CoV-2 highlight the need to find conserved neutralizing epitopes for therapeutic antibodies and efficient vaccine design. Here, we identified a receptor-binding domain (RBD)-binding antibody, XG014, which potently neutralizes β-coronavirus lineage B (β-CoV-B), including SARS-CoV-2, its circulating variants, SARS-CoV and bat SARSr-CoV WIV1. Interestingly, antibody family members competing with XG014 binding show reduced levels of cross-reactivity and induce antibody-dependent SARS-CoV-2 spike (S) protein-mediated cell-cell fusion, suggesting a unique mode of recognition by XG014. Structural analyses reveal that XG014 recognizes a conserved epitope outside the ACE2 binding site and completely locks RBD in the non-functional "down" conformation, while its family member XG005 directly competes with ACE2 binding and position the RBD "up". Single administration of XG014 is effective in protection against and therapy of SARS-CoV-2 infection in vivo. Our findings suggest the potential to develop XG014 as pan-β-CoV-B therapeutics and the importance of the XG014 conserved antigenic epitope for designing broadly protective vaccines against β-CoV-B and newly emerging SARS-CoV-2 variants of concern.
Angiotensin-Converting Enzyme 2 ; Antibodies, Neutralizing ; Antibodies, Viral ; COVID-19 ; Epitopes ; Humans ; SARS-CoV-2/genetics* ; Spike Glycoprotein, Coronavirus/genetics*

Objective: To investigate the household eye hygiene among students at grades 3 to 5 in primary schools in Jinshan District, Shanghai Municipality, so as to provide insights into the management of myopia among children and adolescents. Methods: Students at grades 3 to 5 in primary schools were sampled in Jinshan District using a stratified cluster sampling method from December 2021 to January 2022. The household reading environments were observed, including the height of the learning desk and chair, desk surface color and strength. The duration of reading and writing, duration of watching TV and videos, duration of outdoor activities, duration of sleep and eye use behaviors and habits after school and at weekends were investigated using questionnaires. Results: A total of 330 primary school students were surveyed, including 179 boys (54.24%) and 151 girls (45.76%), and there were 36.36% grade 3 primary school students, 36.36% grade 4 students and 27.27% grade 5 students. There were 94.24% of primary school students that used the desk and chair with heights mismatched to students' heights, 25.45% that used desks with dark surface, 26.67% that used desks with light reflection, and 48.48% that used desk lamps with an illumination intensity of <300 lx. There were 56.36% of students with reading and writing duration of 1 h and longer, 15.76% with watching duration of 0.5 h and longer, 86.97% with outdoor activity duration of <1 h and 88.48% with sleep duration of <10 h after school, and 42.42% with reading and writing duration of 2 h and longer, 29.70% with watching duration of 1 hour and longer, 65.45% with outdoor activity duration of <2 h and 55.76% with sleep duration of <10 h at weekends. There were 30.91% of primary school students with 10 cm distance from chest to desk, 26.36% with 33 cm distance from eyes to books and 35.15% with 3 cm distance from fingers to pen points when reading and writing, and 35.45% with >3 m distance from TV, 40.91% with >50 cm distance from computers, and 22.73% with >40 cm distance from cell phones when watching TV or videos. Conclusions The household eye use environments remain to be improved, and there are poor eye use behaviors among primary school students at grades 3 to 5 in Jinshan District, Shanghai Municipality; notably, mismatch between the desk and chair height and students' body height and inadequate sleep are common.

The coronavirus disease 2019 (COVID-19) pneumonia is a recent outbreak in mainland China and has rapidly spread to multiplecountries worldwide. Pulmonary parenchymal opacities are often observed during chest radiography. Currently, few caseshave reported the complications of severe COVID-19 pneumonia. We report a case where serial follow-up chest computedtomography revealed progression of pulmonary lesions into confluent bilateral consolidation with lower lung predominance,thereby confirming COVID-19 pneumonia. Furthermore, complications such as mediastinal emphysema, giant bulla, andpneumothorax were also observed during the course of the disease.

Objective To explore the pathogenesis of ovarian cancer by investigating the function of Toll-like receptor 1 (TLR1),TLR2 and TLR6 in peripheral blood mononuclear cell(PBMC) from patients with ovarian cancer.Methods PBMC,SK OV 3 co culture system and anti-TLR1,anti-TLR2,anti-TLR6 mAb blocking experiment were used to explore the relationship between TLR1,TLR2 or TLR6 signaling and inflammation in ovarian cancer.Quantitative real time PCR was used to measure interleukin(IL)-1β,IL-6,IL-8,and tumor necrosises factor(TNF)-α in the PBMC.MyD88,TRAF6,TANK,NF-κB and P-NFκB were observed by Western blotting.Results In the PBMC and SK-OV-3 coculture system,we found the activation of TLR signaling pathways,including significantly increased MyD88,TRAF6,TANK and P-NF-κB levels following cocultured with SK-OV-3 in PBMC from ovarian cancer patients.PBMC derived from ovarian cancer patients led to a increase in IL-1β,IL-6 and IL-8 mRNA levels after 24 hours of co-incubation with SK-OV-3 (Fold=1.74,Fold=1.92,Fold=1.65,P＜0.05),though there was no difference of TNF-a mRNA expression.In contrast to the ovarian cancer patients,coculture of PBMC derived from benign diseases controls and healthy normal controls decreased IL-1β at the mRNA level (Fold=0.71,P＜0.05;Fold=0.72,P＜0.05),furthermore the expression of MyD88,TRAF6,TANK,P-NF-κB,and NF-κB showed no changes.PBMC which treated with anti-TLR1,anti-TLR2 or-TLR6 mAb could inhibite inflammatory IL-1β (Fold=0.16,Fold=0.31,Fold=0.29,P＜0.05) and IL-6 (Fold=0.14,Fold=0.20,Fold=0.28,P＜0.05).Conclusion TLR1/TLR2/TLR6 in PBMC of ovarian cancer patients participate in the recognition of the factors.

Objective To evaluate the outcomes of distal leg and foot-ankle reconstruction with rotated single pedicel reverse sural neurocutaneous island flaps. Methods From June 2011 to January 2016, seventeen distal leg and foot-ankle defects cases repaired with rotated single pedicel reverse sural neurocutaneous island flap were analyzed retrospectively. In this study, 13 cases were male, and 4 cases were female. Age ranged from 25 to 65 years old, with an average age of 42.0 ± 8.3 years. Seven cases were distal leg defects, 3 cases were ankle defects, 3 cases were heel defects, and 4 cases were acrotarsium defects; all cases had bone and tendon exposure. The defects ranged from 5.0 cm × 7.0 cm-6.0 cm × 12.0 cm. The flap size ranged from 5.0 cm × 7.0 cm-8.0 cm × 15.0 cm. Results All 17 cases survived completely, without thanatosis, blisters and vascular crisis. The follow-up period was 12-48 months, and the mean was (20.0 ± 11.1) months. The color and elasticity of the flaps was excellent, with satisfactory appearances. Function and appearance of donor sites was not affected. Conclusions The rotated single pedicel reverse sural neurocutaneous island flaps have no injury on main nerves and arteries. The flaps have wide rotation angle and less invalid fold in the pedicel. The simple operation has satisfactory effects and high survival rate. It is a relatively easy procedure that can be applied toward repairing of distal leg and foot-ankle soft tissue defect.

Objective To understand the infection situation of human T lymphocyte virus(HTLV) among blood donors in Zhongshan area.Methods Blood samples from 40 874 blood donors in Zhongshan from March to December 2016 were screened for HTLV antibody by using,enzyme linked immunosorbent assay(ELISA).The positive samples were reexamined two times,and specimens with positive results of reexamination were detected by using immunohistochemical method(CLIA).Then the positive samples were confirmed by Western blot(WB),and confirmed positive samples were judged as infection.Results Of all 40 874 cases of voluntary blood donors,21 cases were positive with HTLV antibody detected by ELISA,the positive rate of ELISA was 0.05%.Five cases were positive detected by CLIA method.One case was confirmed by WB,and the infection rate was 0.002 4%.Conclusion In order to ensure the safety of blood transfusion and reduce blood transfusion infection of HTLV,it might be necessary to perform HTLV screening in first-time blood donors in Zhongshan area.

Objective To evaluate the outcomes of thumb reconstruction with dorsal thumb rotated single pedicel reverse island flap.Methods 49 thumb-tip defects cases with dorsal thumb rotated single pedicel reverse island flap were analyzed retrospectively.37 dorsal thumb reverse island flap were performed,and 12 ulnar-dorsal reverse island flaps were performed.Results The operation time was 40-60 minutes.The mean time was 45 minutes.All 49 cases survived completely.The color of the flaps was purple,and blisters in the surface of the flaps after 1-2 days in 2 cases.After took out stitches partly,the blisters were dried and crusted,the color of the flaps with better blood circulation was normal.The follow-up period was 3-24 months,all thumbs had satisfactory appearances and functions.The two-point discrimination was 6-9mm in flaps inosculated with nerve,that was 8-10 mm in flaps inosculated without nerve.The color,texture and elasticity of flaps were excellent,and the donor sites had not been defected.Conclusion Dorsal thumb rotated single pedicel reverse island flap is a reliable option to restore function as well as appearance,long vascular pedicle with skin strap,wide rotation angle,high rate of survival.It avoided damages to the well-known arteries and nerves.It is a relatively facile procedure that can be applied toward resurfacing thumb tip defects.

Based on analyzing the classification catalog of medical device for rehabilitation, combined with the example,this paper discusses the principle of judgment of the classification of medical device for rehabilitation, and the naming and technical standards related to classification, puts forward the suggestions of classification management,attributes definition, and the naming, in order to provide support for promoting the reform of medical device classification management, and improving the level of scientific supervision.

Objective To investigate the lens and pituitary dose impacted by additional filtration and collection field in head and neck DSA examinations. Methods All images were acquired by a Philips ALLura Xper FD 20 DSA machine. The combination of the different collection fields (48 cm, 42 cm, 31 cm, 22 cm) and additional filtrations (0.9 mmCu+1.0 mmAl, 0.4 mmCu+1.0 mmAl, 0.1 mmCu+1.0 mmAl) were adjusted when the anthropomorphic phantom filled with dosimeter was scanned in anterioposterior and lateral positions with 2D?DSA and 3D?DSA. The dose area product (DAP), air kerma (AK) and the radiation dose values of bilateral lens and pituitary were measured and recorded. The 2D and 3D?DSA regional absorption dose on lens and pituitary were analyzed using t' test, the correlations between DAP and AK parameters and different regional absorption doses were evaluated by Pearson rank correlation coefficient. Results Absorption doses of left lens, right lens and pituitary with 2D?DSA (n=12) were as following:(2.77 ± 0.68), (6.23 ± 3.54), (8.65 ± 2.62) mGy, while the parameters with 3D?DSA (n=12) were (1.78 ± 0.82), (2.18±1.15), (3.32±0.64) mGy, respectively;the results revealed a significant difference (t'=3.20, 3.76 and 6.85, P<0.01). DAP [(8 739±5 731) mGy·cm2] had a relationship with absorption dose of pituitary, left lens and right lens [(5.988 ± 3.299),( 2.258 ± 0.872),( 4.207 ± 3.303) mGy, r values were 0.766, 0.684, 0.727; P<0.01]. AK values was (31 ± 23) mGy and it had a relationship with pituitary absorption dose (r value was 0.894, P<0.01). The lens dose was reduced when the additional filtration was increased and the collection field was decreased, the radiation dose of the pituitary was reduced when both the additional filtration and the collection field were increased. Conclusions In the head and neck DSA examinations, the radiation dose of the lens and the pituitary had different changes with the different additional filters and collecting fields. The organ dose with 3D?DSA was significantly less than that with 2D?DSA.