Objective:To investigate the current situation of diet management in patients with colorectal cancer after stent-based diverting technique, and to provide basis for formulating relevant nursing intervention strategies.Methods:Objective sampling method was used to conduct semi-structured interviews on 15 patients who underwent stent-based diverting technique for colorectal cancer and had the bypass tube removed from Sir Run Run Shaw Hospital Affiliated to Medical College of Zhejiang University from March to July 2023. The interview outline was established based on information-motivation-behavioral skills(IMB) model, and the data were analyzed, summarized and extracted by Colaizzi 7-step analysis method.Results:There were 10 males and 5 females, aged 34-76 years old. According to the three elements of the IMB model, the current situation of diet management was summarized into nine themes. The information included the difficulty in obtaining effective diet guidance information, the lack of specific diet guidance content, the need for individualized diet information guidance mode, and the poor continuity of information exchange after discharge. The motivations included ignoring the importance of diet management, dislike the taste of oral nutritional preparations, and weak support from family members. Behavioral skills include inadequate tube care skills and lack of oral nutrition preparation skills.Conclusions:There are many problems in the diet management of patients after colorectal cancer stent-based diverting technique. Medical staff should optimize the diet education information of colorectal cancer patients after surgery, provide multi-level, multi-time and multi-form continuous care, mobilize the active participation of family members, improve the motivation of patients′ diet management, refine the nursing process of the bypass tube, strengthen the application guidance of oral nutrition preparation skills, and improve patients′ diet management ability.

Objective: To explore the effect of breastfeeding duration on age at adiposity rebound, and provide a scientific theoretical basis for identifying early life factors of obesity in children and adolescents, while promoting early intervention. Methods: In September 2019, first graders from a primary school in Minhang District, Shanghai, were selected to participate in this study, and their growth information was retrospectively collected. The natural cubic spline function was used to fit the body mass index trajectory of the subjects from 1 to 80 months, and age at adiposity rebound was calculated. A total of 6 148 subjects were selected, and complete data of adiposity rebound timing and breastfeeding duration were obtained. A multiple linear regression model was used to analyze the relationship between these two variables. Results: The average breastfeeding duration of all children included in the study was (3.71±3.28) months, and most of the subjects (69.63% for male and 70.45% for female) were breastfed for less than 4 months. A positive linear relationship was found between them [male, B =0.16(0.02-0.30), female, B =0.34(0.18- 0.51 ), total, B =0.23(0.12-0.34), P <0.05]. The linear relationship was determined using the multivariate model. Conclusion Breastfeeding duration independently affected age at adiposity rebound. Prolonging the duration of breastfeeding within 24 months of age may help to delay the timing of adiposity rebound,and thus reduce later risks of overweight and obesity.

Objective: To explore the influence of birth weight and growth patterns during infancy on overweight and obesity among first grade primary school pupils, so as to provide a theoretical basis for the formulation of early life prevention and intervention policies. Methods: In 2019, data related to routine physical examinations were collected for primary school pupils in the Minhang District of Shanghai, and information regarding birth and follow ups was collected retrospectively. Physical examination data of 4 434 pupils at 12 months of age were obtained. A multiple linear regression model was used to analyze the relationship between growth patterns during infancy and body mass index (BMI) in the first grade of primary school. A generalized linear model was employed to analyze the relationship between birth weight and growth patterns during infancy and overweight and obesity in the first grade of primary school. A hierarchical analysis was conducted. Results: A linear relationship was observed between growth patterns during infancy and BMI and the BMI Z score of first grade primary school pupils [ β(β 95%CI)=0.30(0.24-0.35),0.12(0.10- 0.15 ), P <0.01]. In addition to subjects classified as small for gestational age (SGA), catch up growth during infancy was identified among subjects who were classified as appropriate for gestational age (AGA) and large for gestational age (LGA). LGA at birth and catch up growth during infancy were independent risk factors for overweight and obesity among first grade primary school children ( RR =1.31-1.55, P <0.05). The hierarchical analysis showed that catch up growth increased the risk of overweight and obesity among first grade primary school pupils classified as AGA [ RR(RR 95%CI )=1.74(1.42-2.14),1.87(1.56-2.26)], and increased the risk of obesity among first grade primary school pupils classified as SGA and LGA [ RR(RR 95%CI )=3.74(1.04-13.49),3.24(1.62-6.46)]( P <0.05). Among those who exhibited catch up growth during infancy, LGA increased the risk of obesity among first grade primary school pupils ( RR= 2.60 , 95%CI=1.35-5.02, P <0.01), but not the risk of being overweight ( P =0.13). Conclusion Birth weight and growth patterns during infancy have an impact on overweight and obesity among children in the first grade of primary school. It is suggested that attention should be paid to growth and physical development in early life for those classified as LGA and AGA, and catch up growth in children should be closely monitored.

Objective: To explore the characteristics of the adiposity peak and rebound in early life among first year primary school students with different body weight measures, so as to provide scientific evidence for the development of prevention interventions to manage childhood overweight and obesity. Methods: A total of 2 330 first year primary school students who received routine physical examinations from September to December in 2019 were selected. According to body mass index (BMI) status, participants were divided into three categories:healthy weight, overweight, and obese. The BMI growth trajectories of the three groups were fitted by gender using the generalized additive mixed model from 1 to 80 months, retrospectively. Each subject s age at the adiposity peak and rebound, and associated BMI values, were calculated. Results: The prevalence of overweight and obesity was 16.31 % (380/ 2 330 ) and 16.09% (375/2 330), respectively. For first year students with obesity, the BMI value continued to be higher than their overweight or healthy weight counterparts during the first 80 months of life. The age at the adiposity peak for these students, whose BMI status varied, was about nine months. However, the BMI of children with overweight or obesity was much higher than that of healthy weight subjects. Age at adiposity rebound was 72 months for healthy weight children, 52 to 55 months in children defined as overweight, and 22 to 23 months in children with obesity. For healthy weight children, the fitted value of BMI at the adiposity rebound was less than that of overweight and obese children. Conclusion Age at the adiposity peak was largely similar among first year students with different BMI patterns; however, age at adiposity rebound was different. Age at adiposity rebound among children with obesity was much earlier than that of other subjects, and their BMI values were much higher.

Objective: To investigate the development of public health human resource of the Centers for Disease Control and Prevention (CDCs) in Zhejiang Province from 2016 to 2020, so as to put forward the strategies for the talent team construction of CDCs. Methods: The general information of personnel of CDCs in Zhejiang Province from 2016 to 2020 was collected through China Information System for Disease Control and Prevention. A questionnaire survey and a qualitative interview were conducted to collect the data of staffing, talent training, salary and employee turnover, and to analyze the development of the talent team of CDCs. Results: By 2020, there were 105 CDCs, including 1 provincial, 11 prefectural and 93 county-level CDCs, and 5 277 staff on-the-job. From 2016 to 2020, the number of staff per 10 000 permanent residents in the province, prefecture and county levels were 0.062-0.070, 0.170-0.188 and 0.585-0.604, respectively, which did not meet the standard for the personnel establishment in Zhejiang CDCs; the proportion of the staff with bachelor degree or above increased from 90.05% to 94.25%; the proportion of the health professionals decreased from 82.91% to 80.01%; the proportion of the staff with senior professional titles increased from 35.20% to 45.25%. The results of the qualitative interview indicated a lack of health professionals and high-end talents, a gap between the approved staffing and post requirements, as well as demands for a stable team and higher pay. Conclusion From 2016 to 2020, the structure of educational background, major and professional title among the on-the-job staff of CDCs in Zhejiang Province has been improving; however, the total allocation of human resource is insufficient, and the stability and treatment of staff need to be further improved.

Objective:To investigate the comfort of postoperative rectal cancer patients with indwelling anal tube and analyze the influencing factors, so as to provide a basis for the formulation of prevention and improvement measures.Methods:The subjective comfort self-report method of digital score and visual analog score was used to investigate and analyze 64 patients with indwelling anal canal in anorectal surgery.Results:The main discomfort of patients with indwelling anal tube were difficulty in sitting and getting in and out of bed, of which 43 cases (61.9%) reported moderate and severe sitting difficulty, and 30 cases (46.88%) reported moderate and severe difficulty in getting up and down the bed. The exposed length of anal canal was the influencing factor of discomfort ( Fvalues were 22.018, 18.213, P<0.01). Conclusion:Rectal cancer patients with indwelling anal tube have serious difficulties in sitting position and getting in and out of bed. Corresponding measures should be taken according to the influencing factors and effective intervention methods should be used to improve the comfort of the patients.

Objective To investigate the methods of screening specific aptamers for (EpCAM)Gpositive prostate cancer (PCa)cells by cellGSELEX technique.Methods A random DNA library was designed to screen EpCAMGspecific DNA aptamers from human prostate cancer cells expressing EpCAM molecule by cellGSELEX technique.After 12 rounds of in vitro screening,DNA products were cloned and sequenced.Flow cytometry and cellular immunofluorescence were used to detect the specific binding ability of aptamers to target cells.Results Two aptamers of Ep1 and Ep2 were selected.Both of them could specifically bind to EpCAMGpositive cancer cells LNCap,PCG3 ,DU1 45 , and HEK293T cells transfected with target molecule.The binding rates of Ep1 were 61.0%,74.3%,5 9.1% and 60.3%.The binding rates of Ep2 were 65.1%,77.8%,54.2% and 58.3%.Neither of them could bind to HEK293T cells transfected with empty vector with the binding rate of 5.4% in Ep1 and 3.3% in Ep2,respectively.Flow cytometry analysis and confocal images indicated that the EpCAM aptamers could specifically recognize human PCa cells expressing EpCAM,but could not bind to EpCAMGnegative cells.Conclusion EpCAM aptamers derived from cellGSELEX technology can recognize and bind to EpCAMGpositive PCa cells specifically,which may provide new ideas for the specific diagnosis and targeted therapy of prostate cancer,and lay an experimental basis for the other specific diagnosis and treatment schemes of malignant tumors.

OBJECTIVETo explore the effect of acupuncture and moxibustion on severe obesity complicated with hyperlipidemia in different genders and their comprehensive effect, lipid indexes, and obesity indexes.

METHODSA total of 264 patients of severe obesity complicated with hyperlipidemia were assigned into a male group (106 cases) and a female group (158 cases)．According to their clinical symptoms and patterns, acupuncture and moxibustion differentiation therapies were applied for stomach and intestine heat type, spleen deficiency and dampness resistance type, phlegm-dampness internal resistance type, liver depression and spleen deficiency type, spleen and kidney deficiency type and deficiency and blood stasis type．The obesity indexes were weight (W), obesity degree (A), body mass index (BMI) and body fat percentage (F); the blood lipid indexes were total cholesterol (TC)，triglyceride (TG)，low density lipoprotein (LDL-C) and high density lipoprotein (HDL-C). The comprehensive effect, obesity and blood lipid indexes were observed．.

RESULTSThe total effective rate of the male group was 91.5% (97/106), and the total effective rate of the female group was 85.4% (135/158) , without statistical significance (>0.05). After treatment, the obesity indexes of W, A, BMI and F and the blood lipid levels of TC, TG, LDL-C decreased, the levels of HDL-C increased compared with those before treatment in the two groups (<0.05, <0.01). The different values before and after treatment of the above all indexes in the male group were higher than those in the female group (all <0.05).

CONCLUSIONAcupuncture and moxibustion can both improve the obesity and blood lipid indexes for the patients with obesity complicated with hyperlipidemia. The effect is better for male than for female. The methods can prevent and treat hyperlipidemia.

How to give full play to the advantages of rehabilitation institutions, and to improve service quality and administration efficiency are some of the complex issues faced by the high-level administrators of rehabilitation institutions. This paper studied a total of 67 institutions to investigate the operation and management model of rehabilitation institutions in China, as well as their advantages and disadvantages.

The establishment of an efficient performance management system is crucial for a rehabilitation institution. This article discussed the concept of performance, performance management and ways to establish an efficient performance management system.