Objective To probe into the reliability and validity of the questionnaire on clinical pathways and patients' satisfaction.Methods Investigating the hospital patients' satisfaction with the questionnaire designed by the former Ministry of Health and analyzing the internal consistency and constructive validity through statistical methods.Results Cronbach' s α coefficient of the adjusted questionnaire was 0.947 and those of the each subscale were 0.563,0.968 and 0.820.The split-half reliability of the questionnaire was 0.869.The number of factors is 3 as same as the designed assuming structure,and the cumulative contribution rate of 3 factors was 74.178％.The factor loading of each item was above 0.4,each item of a common factor with a higher load factor.Conclusion Although there are differences from hospital to hospital,this questionnaire is applicable to investigating patients' satisfaction of the clinical pathway management mode in view of the statistical and clinical practice.

Objective To explore the associations of anxiety with optimism ,resilience and related demographic factors in lung cancer patients , and to provide a scientific basis for reducing the level of anxiety and improving the psychosomatic health. Methods A total of 130 lung cancer pa-tients from the department internal medicine of respiratory tumors in Liaoning Cancer Hospital&Institute were investigated by convenience sam-pling method from February 2013 to January 2014. The survey was anonymous. Finally,107 questionnaires were effective,and the effective rate was 82.307%. Results Among lung cancer patients,optimism and resilience were positively and significantly associated with anxiety. Physical ex-ercise had an effect on the anxiety symptoms. Conclusion Optimism and resilience have significant predictive value on the anxiety among lung cancer patients. It is important to encourage lung cancer patients to improve their psychological health ,so as to reduce their anxiety symptoms effec-tively.

Objective To study the expression of the excision repair cross complementing 1 ( ERCC1 ) and thymidylate synthase ( TS) in gastric cancer and to investigate the correlation between the ERCC 1 and TS ex-pression with the efficacy of FOLFOX adjuvant chemotherapy in gastric cancer patients .Methods A total of 73 gastric cancer patients received modified FOLFOX adjuvant chemotherapy .Real-time PCR was used to investi-gate the expression of ERCC 1 and TS in gastric cancer tissue .We also studied their correlation and association with prognosis .Results ERCC1 and TS expressed in gastric cancer tissues with the positive rate were 42 .5%(31/73)and 61.6%(45/73).There was no significant correlation between the ERCC 1 or TS expression and the clinical features .In this study ,the median of RFS and MST were 16 months and 27 months in patients with ER-CC1-negtive expression,9 months and 16months in patients with ERCC1-positive expression,the median of RFS and MST were significantly different in the two groups (P=0.000,P=0.002).There were no statistical differences on TS expression pattern in either median of RFS or MST (P=0.10,P=0.71).Conclusion The ex-pression of ERCC1 may be useful in prediction of the clinical outcome in gastric cancer patients who treated with FOLFOX7 adjuvant chemotherapy .Patients with ERCC1-negtive expression may benefit from the therapy .

Objective This study is based on the physicians'appraisal system upon HIS system to annually assess the associate chief physicians in clinical departments in the mode of attending in charge. Methods 74 doctors above the title of associate chief physician from 14 departments in such mode were selected as objects of study and evaluated upon relative requirement of the performance appraisal index system by means of brainstorming,expert consulting and so on to confirm the content,standard and scoring method of appraisal.Work efficiency index and work amount can be acquired out of HIS system, while details and problems during the assessment can be dealt together with clinical practice.Finally all index and results were collected through HIS system and total scores of relative doctor can be automatically calculated.SPSS 13.0 statistics software also can be used to descriptively analyze the frequency and percentage data.Results The total appraisal scores and scores in every grade of the 74 doctors,who are attending in charge with title above associate chief physician as well as bearing the same responsibility in both medicine and surgery department,were collected,analyzed and respectively ranked respectively.Conclusion The results of appraisal basically indicate general level of the doctors,as well as provide strong evidence for enhancing human resource management of the hospital, which will continuously improve the basis for assessment to performance of associate chief physician under mode of attending in charge,as well as collect experiences for deeply optimizing program of assessment system.

Abstract: Objective To analyze the distribution characteristics of new occupational disease cases in Guangxi Zhuang “ ” Methods Autonomous Region (hereinafter referred to as Guangxi ) from 2016 to 2021. Through the Occupational Disease Report Card of Occupational Disease and Occupational Health Monitoring Information System, a subsystem of China Disease Prevention and Control Information System, the data of occupational disease reported in Guangxi from 2016 to 2021 were Results collected and analyzed by routine data analytic method. A total of 633 new cases of occupational diseases were diagnosed in Guangxi from 2016 to 2021. Most of the cases occurred in males that account for 96.5% (611/633). Among them, 85.8% of cases were occupational pneumoconiosis, 6.3% occupational otoaryngological and stomaological diseases, 3.0% chemical poisoning and 4.9% other five types of occupational diseases. The geographical distribution was dominated in Hechi Citythataccountsfor51.7%.Theindustrialdistributionwasconcentratedinbituminouscoalminingandwashing,tinminingand dressing, lead and zinc mining and dressing (43.1% of the total). Private enterprises account for 47.3%. The enterprise was - mainlysmall sizedenterprises,accountingfor50.0%.Themaintypesofworkwererockdrillsandmaincoalminer,accountingConclusion for18.8%and17.5%,respectively. Occupationalpneumoconiosiswasthemostimportantoccupationaldiseasein Guangxi. It is necessary to strengthen the occupational hazard exposure control and protection of bituminous coal mining and - - washing,tinmininganddressing,leadandzincmininganddressingindustries,privateenterprises,andsmall andmedium sized enterprises,rockdrillsandmaincoalminerinHechiCity.

Objective To investigate the gut microbial profiles of gestational mellitus diabetes (GDM) patients before and after treatment,and the relationship between gut microbiota and blood glucose level measured in 75 g oral glucose tolerance test (OGTT).Methods A prospective cohort-based nested case-control study was conducted in Peking University First Hospital from October 2016 to December 2017.Forty-five pregnancies at 24-28 gestational weeks with GDM (GDM group) and 45 healthy gravidas (control group)matched for age and pre-pregnancy body mass index (BMI) were involved.Stool samples of all participants were collected before (24-28 gestational weeks) and after (36-40 gestational weeks) treatment.The V3-V4 region of the 16S rRNA gene was sequenced on the Illumina Hiseq 2500 platform,and the results were analyzed.QIIME software was used for bioinformatics analysis.Student's t-test,Mann-Whitney U test,and Chi-square test were used for statistical analysis.Results (1) Before treatment,the Alpha diversity of the GDM group was significantly reduced compared with that of the control group (Chaol index:443.9±72.9 vs 474.0± 63.3,t=2.104,P＜0.05;Shannon index:5.6±0.5 vs 6.0±0.5,t=2.002,P＜0.05),and a significant difference in Beta diversity was also observed between the two groups (R2=0.04,P＜0.05).However,a significant difference was shown in neither Alpha nor Beta diversity between the two groups after the treatment.(2) Before treatment,the relative abundances of Blautia and Faecalibacterium of the GDM group were significantly higher than those of the control group [M (P25-P75):0.016 (0.009-0.022) vs 0.011 (0.007-0.016),U=782.000;0.114 (0.076-0.14 1) vs 0.091 (0.061-0.126),U=752.000;both P＜0.05],but the relative abundances ofAkkermansia,Odoribacter and Butyricimonas were significantly lower [0.001 (0.000-0.002) vs 0.001 (0.000-0.005),U=745.000;0.001 (0.000-0.004) vs 0.004 (0.001-0.006),U=766.500;0.001 (0.000-0.003) vs 0.003 (0.001-0.005),U=710.000;all P＜0.05].(3) A negative relationship was found between the fasting glucose level of OGTT and the relative abundances of Akkermansia,Odoribacter and Butyricimonas (r=-0.325,-0.273 and-0.284;all P＜0.05),and between the one-hour-OGTT glucose level and the relative abundances of Akkermansia and Butyricimonas (r=-0.285 and -0.265,both P＜0.05).The two-hour-OGTT glucose level was positively related to the relative abundance of Faecalibacterium (r=0.278,P＜0.05),but negatively related to the relative abundance ofAkkermansia (r=-0.245,P＜0.05).The area under the OGTT time-glucose curve was negatively related to the relative abundances of Akkermansia and Butyricimonas (r=-0.321 and-0.264,both P＜0.05).Conclusions There are significant differences in gut microbial composition and structure between GDM and healthy pregnant women,which are significantly associated with OGTT blood glucose level.Euglycemia achieved after GDM management could improve gut microbiota disorder.