Construction of A Smart Hospital Innovation Platform Using the Internet + Technology.

Objective: This study aims to investigate the practical application of "Internet + technology" leveraging medical big data to enhance the development of a smart hospital platform. Specifically, the focus is on optimizing patient care processes, refining medical data management systems, and enhancing operational efficiency within the hospital setting. Methods: With the help of traditional Internet and mobile Internet technology, we analyzed the patient behavior big data accumulated in our hospital for many years, simplified the diagnosis and treatment links, refined the service connotation, and improved patient satisfaction before, during and after diagnosis; With the help of barcode, RFID and 5G networks, the links that are easy to produce medical security incidents can be monitored to improve medical quality, such as digital operating room system, establishment of multidisciplinary consultation center (MDT), electronic medical record system based on digital signature, etc.; Integrate the existing data of human resources, equipment and consumables, drugs, general supplies and finance, establish the hospital ERP system, introduce BI, and realize the dynamic monitoring of revenue and cost; Artificial intelligence technologies such as natural language processing (NLP) and machine learning are used to extract, clean, transform and analyze a large number of hospital medical information data to form a medical data platform, which can assist the hospital knowledge base to be applied in diagnosis and treatment, clinical research, clinical medicine, clinical medicine and other fields. The effectiveness of these technologies was assessed through a comprehensive analysis of their impact on patient care processes, medical data management, and overall operational efficiency within the hospital setting. Results: The study yielded significant outcomes across three critical domains. Firstly, in patient care, the implementation of expanded mobile medical services, mobile applications for records and rounds, and the establishment of digital signature-based records and intelligent surgical assistance enhanced accessibility and quality of care. Secondly, operational efficiency was notably improved through the integration of ERP and BI systems, streamlining resource management and surgical procedures. Lastly, advancements in data management, including the development of a medical data platform and the deployment of AI technologies, facilitated efficient analysis and utilization of clinical data. Quantitatively, reductions in patient visit time and medical costs were observed, alongside improved diagnostic accuracy facilitated by comprehensive records. These findings collectively underscore the transformative impact of "Internet + technology" integration on hospital operations and patient outcomes. Conclusion: The integration of "Internet + technology" in a smart hospital setting has demonstrated numerous benefits. This study has revealed novel findings regarding the tangible improvements in patient outcomes and hospital efficiency resulting from technology integration. Specifically, the implementation of mobile medical services, digital records, and AI-driven systems has led to significant reductions in patient visit times and medical costs. Moreover, the streamlining of operational processes through ERP and BI systems has enhanced resource management and surgical procedures. These findings underscore the transformative potential of technology in revolutionizing healthcare delivery, ultimately leading to better patient care and operational effectiveness in smart hospital environments.

Comparison of azvudine, molnupiravir, and nirmatrelvir/ritonavir in adult patients with mild-to-moderate COVID-19: a retrospective cohort study.

This study aimed to explore the effectiveness and safety of azvudine, nirmatrelvir/ritonavir, and molnupiravir in adult patients with mild-to-moderate COVID-19. This retrospective cohort study included patients with mild-to-moderate COVID-19 (asymptomatic, mild, and common types) at the First Hospital of Changsha (Hunan Province, China) between March and November 2022. Eligible patients were classified into the azvudine, nirmatrelvir/ritonavir, or molnupiravir groups according to the antiviral agents they received. The outcomes were the times to nucleic acid negative conversion (NANC). This study included 157 patients treated with azvudine (n = 66), molnupiravir (n = 66), or nirmatrelvir/ritonavir (n = 25). There were no statistically significant differences in the time from diagnosis to NANC among the azvudine, molnupiravir, and nirmatrelvir/ritonavir groups [median, 9 (95% CI 9-11) vs. 11 (95% CI 10-12) vs. 9 (95% CI 8-12) days, P = 0.15], time from administration to NANC [median, 9 (95% CI 8-10) vs. 10 (95% CI 9.48-11) vs. 8.708 (95% CI 7.51-11) days, P = 0.50], or hospital stay [median, 11 (95% CI 11-13) vs. 13 (95% CI 12-14) vs. 12 (95% CI 10-14) days, P = 0.14], even after adjustment for sex, age, COVID-19 type, comorbidities, Ct level, time from diagnosis to antiviral treatment, and number of symptoms. The cumulative NANC rates in the azvudine, molnupiravir, and nirmatrelvir/ritonavir groups were 15.2%/12.3%/16.0% at day 5 (P = 0.858), 34.8%/21.5%/32.0% at day 7 (P = 0.226), 66.7%/52.3%/60.0% at 10 days (P = 0.246), and 86.4%/86.2%/80.0% at day 14 (P = 0.721). No serious adverse events were reported. Azvudine may be comparable to nirmatrelvir/ritonavir and molnupiravir in adult patients with mild-to-moderate COVID-19 regarding time to NANC, hospital stay, and AEs.

[Water Quality Change Trend and Risk Analysis of Wuhan Hanjiang River Water Source].

Hanjiang River is closely related to the middle route of the South-to-North Water Diversion Project, the Water Diversion Project from the Hanjiang River to the Wei River, and the Water Diversion Project in Northern Hubei. The Wuhan Hanjiang River water source is one of the important drinking water sources in China; its water quality safety is significant to living and production for millions of residents in Wuhan. Based on data from 2004 to 2021, the water quality variation trend and risk of Wuhan Hanjiang River water source were studied. The results showed that a certain gap existed between the concentrations of some pollutants such as total phosphorus, permanganate index, ammonia nitrogen, and correspondent water quality target, especially for the total phosphorus. The growth of algae in the water source was marginally limited by the concentrations of nitrogen, phosphorus, and silicon. When other factors remained unchanged, diatoms tended to grow rapidly when the water temperature was appropriate (6-12℃). The quality of water upstream had a great impact on the water quality of the Hanjiang water source. There may have been pollutants entering into the reach during the West Lake Water Plant and Zongguan Water Plant. There were differences in the temporal and spatial variation trend of concentrations between permanganate index, total nitrogen, total phosphorus, and ammonia nitrogen. Significant changes in the ratio of nitrogen and phosphorus in the water body will affect the population structure and quantity of planktonic algae and ultimately affect the safety of water quality. The water body in the water source area was generally in the state of medium nutrition to mild eutrophication, and middle eutrophication may have occurred in a few periods. In recent years, the nutritional level of the water source has been on the decline. It is necessary to make an in-depth investigation on the source, quantity, and change trend of pollutants in water sources in order to eliminate potential risks.

Circulating mitochondrial DNA is associated with anemia in newly diagnosed hematologic malignancies.

Recent reports discovered that red blood cells (RBCs) could scavenge cell-free mitochondrial DNA (mtDNA), which drives the accelerated erythrophagocytosis and innate immune activation characterized by anemia and inflammatory cytokine production. However, the clinical value of the circulating mtDNA copy number alterations in hematologic malignancies is poorly understood. Our data showed that in comparison to healthy group, the patients group had significantly higher mtDNA and histone H4 levels. Moreover, we observed that RBC-bound mtDNA and histone H4 were negatively correlated with hemoglobin in patients. In addition, cytokines and chemokines levels in patients differed significantly from normal controls (21 higher, 7 lower). Our study suggested that both circulating mtDNA and histone H4 were associated with anemia in hematologic malignancies, which helps to further understand the potential mechanism of anemia development in patients with hematologic malignancies. This information may play a vital role in the specific therapeutic interventions for leukemia in the future.

[Temporal and Spatial Characteristics of Total Phosphorus in the Middle and Lower Yangtze River Mainstem Under New Water and Sediment Conditions].

After the completion of the Three Gorges Reservoir and the upstream reservoir group of the Yangtze River, new water and sediment conditions appeared in the middle and lower reaches of the Yangtze River, and its influence on the phosphorus concentrations in water has attracted much attention. Therefore, the spatial and temporal distributions of total phosphorus (TP) concentrations in the middle and lower reaches of the mainstem under the new water and sediment conditions were studied. The results show that:① after the construction of the Three Gorges Reservoir, the concentrations of TCP (samples were allowed to settle for 30 min) in the middle and lower reaches of the Yangtze River fluctuates between 0.10 and 0.15 mg·L-1, and generally increased during 2004-2010 and then decreased during 2014-2019, and increases along the flow direction. The concentrations of dissolved total phosphorus (TDP) have slowly increased with time. ② The settleable solids influence the phosphorus content to varying degrees. The median values of TCP/TP ratio in Nanjinguan, Hankou, and 23 km below Wusongkou, are 0.900, 0.720, and 0.609, respectively, which decreases successively from upstream to downstream. The proportion of TPP (total particulate phosphorus)/TP shows an increasing trend along the flow direction. The median values of TPP/TP ratios in Nanjinguan, Hankou, and 23 km below Wusongkou were 0.439, 0.567, and 0.738, respectively. ③ According to the "Environmental quality standard for surface water GB 3838-2002", the water quality was assessed using TCP concentrations, and the assessment results showed that the water quality of the middle and lower reaches of the Yangtze River was generally good. However, considering the influence of settleable solids, the water quality categories assessed based on TP concentrations would be worse, especially near estuaries. ④ In the middle and lower reaches of Yangtze River, there is little difference in the phosphorus concentration of different monitoring sites in the upper section of main stream; however, the difference is obvious near the estuary. ⑤ The concentration of TCP in the coastal waters of the urban river section of the middle and lower reaches of the Yangtze River is significantly higher than that of the main channel, and there are obvious coastal pollution zones in the coastal waters of the urban river section.

Heparanase Facilitates PMA-Induced Megakaryocytic Differentiation in K562 Cells via Interleukin 6/STAT3 Pathway.

Heparanase (HPSE) is an endo-ß-D-glucuronidase that cleaves heparan sulfate and hence participates in remodeling of the extracellular matrix, leading to release of cytokines that are immobilized by binding to heparan sulfate proteoglycans (HSPGs), and consequently activating signaling pathways. This function of HPSE is correlated to its expression level that is normally very low in majority of the tissues. Exceptionally, human platelets express high level of HPSE, suggesting a unique physiological role in this cell. Using K562 cell line, we found a progressive increase of HPSE during the megakaryocytic differentiation. Analysis of a series of megakaryocytic differentiation-related heparin-binding proteins (HBPs) in the cell culture medium revealed an exclusive positive correlation between the level of interleukin 6 (IL-6) and HPSE expression. IL-6 modulated megakaryocytic differentiation through activation of STAT3. Further, we demonstrated that overexpression of HPSE potentiates megakaryocytic differentiation, whereas elimination of HPSE led to a delayed differentiation. This function of HPSE is associated with its activity, as overexpression of inactive HPSE had no effect on IL-6 production and megakaryocytic differentiation. The role of HPSE is further supported by the observation in an umbilical cord blood CD34+ cells megakaryocytic differentiation model. Our data propose a novel role for HPSE in platelets production by a HPSE/IL-6/STAT3 positive feedback loop that specifically regulates megakaryocytes maturation.

[Establishment and Application of HPA1-6, 15 Platelet Donor Bank in Beijing Area].

OBJECTIVE: To establise the bank of platelet donors with the human platelet antigen (HPA) 1-6, 15 genes so as to provide the HPA-matched platelets for the patients. METHODS: The HPA genotyping of platelets donors and patients with platelet antibody positive confirmed by sercening was performed by using the SSP-PCR; the efficacy of transfusing the HPA-matched platelets for 37 cases platelet antibody positive was analyzed. RESULTS: The most common genotype in platelet donors were HPA-1a/1a-2a/2a-3a/3b-4a/4a-5a/5a-6a/6a-15a/15b, followed by HPA-1a/1a-2a/2a-3a/3a-4a/4a-5a/5a-6a/6a-15a/15b; the most common genotype in 53 cases of platelet antibody positive confirened by screening were HPA-1a/1a-2a/2a-3a/3b-4a/4a-5a/5a-6a/6a-15a/15b. Among 37 patients with platelet antibody positive confirened by screeming, 28 showed that the transfusion of HPA-matched platelets was effective with statistically significant difference in comparison with random transfusion group. The HPA-3, HPA-15 were the main factors leading to polymorphisms. CONCLUSION: HPA-3 and HPA-15 are polymorphic, which should be focused on. HPA-matched platelets can improve the efficiency of platelet transfusion, and avoid the waste of blood resources. The genotypes of platelet donors can basically meet the requirements for common genotype transfusion.

[Evaluation of Temporal and Spatial Variation Characteristics of Nutrients in Surface Sediment in the Three Gorges Reservoir Area].

With the construction of the Three Gorges Dam, the river flow pattern and sediment dynamics are expected to be affected. As a consequence, the sediment traits could be impacted by these changes. The temporal and spatial variation characteristics of the nutrient content from 2000 to 2015 in surface sediment were analyzed in the main stream from Jiangjin to the dam site section of the Yangtze River and in the estuaries of the representative input tributaries of the Three Gorges Reservoir, such as the Jialing River, Yulin River, Wujiang River, Xiaojiang River, Daning River, and Xiangxi River. Then, the state of the pollution was assessed. Results revealed that the average concentrations of total phosphorus (TP) in the surface sediments of the main stream ranged from 678.2 to 928.6 mg·kg-1, the average contents of total nitrogen (TN) ranged from 0.203% to 0.362%, the average contents of potassium ranged from 1.74% to 2.37%, and the average contents of organic matter ranged from 0.94% to 1.54%. The average concentrations of TP in the estuaries of the representative input tributaries ranged from 490.1 to 832.3 mg·kg-1, the average contents of TN ranged from 0.257% to 0.495%, the average contents of potassium ranged from 1.69% to 2.32%, and the average contents of organic matter ranged from 1.21% to 2.27%. The concentrations of TP and potassium in the study sections were generally within background concentration ranges, while the concentrations of TN were obviously above background levels, and the concentrations of organic matter were obviously below background levels. The nutrient contents in the surface sediment did not display significant differences among the study sites; however, the distributions of different nutrient contents along the river varied widely. Although the nutrient contents in the surface sediments fluctuated somewhat during different flow periods, they were seemingly unaffected by the impoundment, since no obvious enrichment was observed throughout the impoundment. The evaluation of organic index indicated a clean state for the surface sediments in the majority of the study area, while there was a moderately polluted state in some local sections. The evaluation of nitrogen pollution indicated a polluted state for most sections. Overall, the nutrients in the surface sediments of the Three Gorges Reservoir showed moderate ecological risks, possibly caused by TP and TN.

Evaluation of group A1B erythrocytes converted to type as group O: studies of markers of function and compatibility.

BACKGROUND: Enzymatic conversion of blood group A1B red blood cells (RBC) to group O RBC (ECO) was achieved by combined treatment with α-galactosidase and α-N-acetylgalactosaminidase. The aim of this study was to evaluate the function and safety of these A1B-ECO RBC in vitro. MATERIALS AND METHODS: A 20% packed volume of A1B RBC was treated with enzymes in 250 mM glycine buffer, pH 6.8. The efficiency of the conversion of A and B antigen was evaluated by traditional typing in test tubes, gel column agglutination technology and fluorescence-activated cell sorting (FACS) analysis. The physiological and metabolic parameters of native and ECO RBC were compared, including osmotic fragility, erythrocyte deformation index, levels of 2,3-diphosphoglycerate, ATP, methaemoglobin, free Na(+), and free K(+). The morphology of native and ECO RBC was observed by scanning electron microscopy. Residual α-galactosidase or α-N-acetylgalactosaminidase in A1B-ECO RBC was detected by double-antibody sandwich ELISA method. Manual cross-matching was applied to ensure blood compatibility. RESULTS: The RBC agglutination tests and FACS results showed that A1B RBC were efficiently converted to O RBC. Functional analysis suggested that the conversion process had little impact on the physiological and metabolic parameters of the RBC. The residual amounts of either α-galactosidase or α-N-acetylgalactosaminidase in the A1B-ECO RBC were less than 10 ng/mL of packed RBC. About 18% of group B and 55% of group O sera reacted with the A1B-ECO RBC in a sensitive gel column cross-matching test. DISCUSSION: The conversion process does not appear to affect the morphological, physiological or metabolic parameters of A1B-ECO RBC. However, the A1B-ECO RBC still reacted with some antigens. More research on group O and B sera, which may partly reflect the complexity of group A1 the safety of A1B-ECO RBC is necessary before the application of these RBC in clinical transfusion.

[Temporal and Spatial Variation Characteristics of the Heavy Metals Content in the Surface Sediment and the Potential Ecological Risk Trends in the Three Gorges Reservoir Area].

With the construction progress of the Three Gorges Project, the hydrological situation of Three Gorges Reservoir changes greatly, which causes the changes of suspended solids precipitation conditions and surface sediment traits. This research analyzed the temporal and spatial variation of the heavy metal pollution in the surface sediment and the potential ecological risk trends during the years from 2000 to 2015 in the trunk stream of the Yangtze River from Jiangjin to the Three Gorges Dam area and some major tributaries, such as Jialing River, Yulin River, Wujiang River, Xiaojiang River, Xiangxi River. The results showed that the average content ranges of heavy metals (including Cu, Pb, Mn, As, Hg etc.) in surface sediments at the main stream monitoring sections during the study period were 46.5-85.7 mg·kg-1(Cu), 43.8-65.1 mg·kg-1(Pb), 784.2-910.6 mg·kg-1(Mn), 8.44-11.91 mg·kg-1(As), 0.193-0.236 mg·kg-1(Hg) respectively; The average content ranges of the heavy metals in surface sediments at the main stream monitoring sections during the study period were 16.5-85.6 mg·kg-1(Cu), 25.8-74.8 mg·kg-1(Pb), 573.7-996.3 mg·kg-1 (Mn), 6.96-13.31 mg·kg-1 (As), 0.160-0.232 mg·kg-1 (Hg) respectively. The results also showed that there were obvious differences of the heavy metals content in some areas between the left and right bank of the trunk stream of the Yangtze River in the Three Gorges Reservoir area. The results also showed that the concentration variation trends of the heavy metals were different in the surface sediments, such as Cu, Pb, Mn, As and Hg. The content of Hg was the most influenced element by the water period effect. The concentration variation trends of these elements were different at different monitoring sections during the construction and water harvesting progress of the Three Gorges project. The contents of Cu, Pb, Mn and As in sediment from the Three Gorges Reservoir area showed strong positive correlations between each other. But there was a low correlation between the content of As and those of other elements. There was no significant correlation between the content of Hg and those of other heavy metal elements. According to the geoaccumulation index analytical method, the contents of the heavy metals in surface sediments in the Three Gorges Reservoir area were generally at low enrichment level. But the pollution caused by Hg should be paid attention. The change of potential ecological risk index was small in the main stream and the major tributaries of the Yangtze River (except Wujiang River) in most of the time. It should also be noted that the change of potential ecological risk index fluctuated obviously at a high level before the year of 2008, and then the change fluctuations trends descended with time and tended to be stable.

[Evaluation of Storage Performance of Preserving Bags for Manually Separated Platelets].

OBJECTIVE: To evaluate the storage performance of the domestically made platelet storage bags (experimental group) and the United States Trima set platelet storage bags (control group). METHODS: The manually separated platelets were divided in two equal parts, which was added to control blood bags and experimental blood bags respectively, all samples were stored at a 22 °C ± 2 °C. The platelet count, mean volume, aggregation activity (ADP, THR), pH, glucose, lactate concentration, lactate dehydrogenase concentration, hypotonic shock reaction, CD62P and phosphatidic acid serine content were detected at day 0, 3, 5 and 7 of storage. RESULTS: There was no significant difference of platelet quality at day 5 after storage between the experimental group and the control group (T-test, P > 0.05). CONCLUSION: Two kinds of platelet storage bags have the similar storage performance.

Dysregulation of the miR-324-5p-CUEDC2 axis leads to macrophage dysfunction and is associated with colon cancer.

CUEDC2, a CUE-domain-containing protein, modulates inflammation, but its involvement in tumorigenesis is still poorly understood. Here, we report that CUEDC2 is a key regulator of macrophage function and critical for protection against colitis-associated tumorigenesis. CUEDC2 expression is dramatically upregulated during macrophage differentiation, and CUEDC2 deficiency results in excessive production of proinflammatory cytokines. The level of CUEDC2 in macrophages is modulated by miR- 324-5p. We find that Cuedc2 KO mice are more susceptible to dextran-sodium-sulfate-induced colitis, and macrophage transplantation results suggest that the increased susceptibility results from the dysfunction of macrophages lacking CUEDC2. Furthermore, we find that Cuedc2 KO mice are more prone to colitis-associated cancer. Importantly, CUEDC2 expression is almost undetectable in macrophages in human colon cancer, and this decreased CUEDC2 expression is associated with high levels of interleukin-4 and miR-324-5p. Thus, CUEDC2 plays a crucial role in modulating macrophage function and is associated with both colitis and colon tumorigenesis.

Impact on storage quality of red blood cells and platelets by ultrahigh-frequency radiofrequency identification tags.

BACKGROUND: Compared to ISBT128 code labels, radiofrequency identification (RFID) tags have incomparable advantages and gradually applied in blood management system. However, there is no global standard for the uses of RFID frequency. Even though ISBT recommended high-frequency RFID with 13.56MHz, 820- to 960-MHz ultrahigh frequency (UHF) RFID technology in many ways has even more advantages. For this reason, we studied the effect of UHF RFID tags with 820- to 960-MHz exposure on storage quality of red blood cells (RBCs) and platelets (PLTs). STUDY DESIGN AND METHODS: Thirty units of collected and prepared suspended RBCs (sRBCs) and PLTs were divided into two bags, one each for the test and control groups. The sRBCs were stored in 4±2°C refrigerator and the PLTs in a 22±2°C rocking box. The test groups were exposed to RF reader continuously during storage. Sampling at different time points and biologic changes were tested. RESULTS: As the extension of storage and the pH and chlorine levels in the supernatant of sRBCs were reduced, free hemoglobin, potassium, and sodium increased, but were not significant between test and control groups (p>0.05). During the storage period, the pH levels, PLT count, and PLT aggregation rate were decreased in both test and control groups, but were not significant (p>0.05). CONCLUSION: When exposed to 820- to 960-MHz RF, the biologic and biochemical indexes are not found to be exacerbated during 35 days of storage for sRBCs and 5 days for PLTs, respectively.