Objective To explore the differences of occupation burnout of the soldiers in southern and northern Xinjiang and explore its related influencing factors.Methods Using stratified randomization sampling method,500 soldiers from south and north of xinjiang military were selected and investigated by Military Job Burnout Scale and Military Social Support Rating Scale.Results ① The military of northern soldiers'accomplishment,somatization,interpersonal relationship,social support score (5.57±3.29,5.53± 3.35,3.38±2.75,9.62± 10.15) was significantly higher than the soldiers who live in south of xinjiang (5.26±3.25,5.13±3.45,2.94±2.39,6.25±5.24) (t=2.091,-2.539,-4.011,7.227,P＜0.05).②Every dimensions of occupation bumout has significant correlation with social support,age,length of military service,marriage,level,working hours,income and job satisfaction (r=0.124,0.220,0.275,0.198,0.192,0.206,0.188,-0.383,P＜0.05).The total score of Military Job Bumout Scale has positive correlation with social support and level (r=0.122、0.410,P＜0.01).③Social support,working hours,job satisfaction and length of military service has forecast effect on the northern military occupation bumout.Social support and level can predict the southern military occupation burnout.Conclusion It is no obviously differences on the general occupational between the north and South Xinjiang Military.Social support is closely related to the job burnout of South and the North military.

Objective To investigate the mechanism of kuiyusan on recovering intestinal mucosa of patients with active ulcerative colitis(UC). Methods Forty-eight patients with active UC were selected as our subjects. They were applied kuiyusan to retention enema for1 time per day for 15 days as a treatment course. Next treatment course were started interval 7 days and all patients were received 3 treatment courses. Changes of pathological signs were observed before and after the treatment with kuiyusan. Results The rate of intestinal mucosal focal small hemorrhages after treatment was 37. 5 %(18 / 48),significantly lower than that at pre-treatment(87. 5%(42 / 48);χ2 = 25. 60,P < 0. 001). The UC mucosal epithelial regeneration rate,disappear rate of intestinal mucosal epithelial goblet cells and Paneth cells regeneration rate at pre-treatment were 18. 8%(9 / 48),31. 2%(15 / 48),6. 3%(3 / 48),significantly different from that after treatment(50. 0%(24 / 48), 6. 3%( 3 / 48 ),20. 8%( 10 / 48 );χ2 = 10. 39,9. 85,4. 36;P < 0. 01 ). The incidence rate of intestinal lymphocyte hyperplasia and infiltration of eosinophils at pre-treatment were 95. 8%(46 / 48)and 100%(48 /48),higher than that after treatment( 72. 9%( 35 / 48 ) and 56. 2%( 27 / 48 )) and the differences were significant(χ2 = 9. 56,26. 88;P < 0. 01). Crypt abscess incidence were decreased from 56%(27 / 48)at pre-treatment to 25%(12 / 48)at after treatment( χ2 = 9. 72,P < 0. 01). Conclusion Kuiyusan can obviously improve small vascular lesions and crypt abscess of the mucous membrane on active UC,reduce neutrophil, eosinophil infiltration,maintain the intestinal epithelial tight junction,improve mucosal barrier,as well as promote healing of mucosal inflammation.

ObjectiveTo observe the effect of Kuiyu dection on ulcerative colitis and to explore its mechanism.Methods120 patients with ulcerative colitis were randomly divided into a treatment group and a control group,60 cases in each group.The treatment group was treated with Kuiyu dection retention enema,1 time a day,15 days for a course of treatment; and the control group was treated with SASP orally,2 g every time,3 times a day,and 15 days for a course of treatment.All patients with a course of treatment for the next 7 days after the rest period of treatment,evaluated after 3 courses.Comprehensive clinical efficacy,the main symptoms,score of integral electronic colonoscopy examination,and the changes of IL-6,IL 8 levels were observed in both groups after treatment with complete remission and six months followed-up,besides,the recurrence rate was also observed.ResultsThe total effective rate was 93.33％ in the treatment group,better than the control group 78.33％ (x2 =9.027,P＜0.05) ; the treatment group also showed better results in diarrhea,pus and blood improvement than the control group (x2=5.630、x2=5.972,P＜0.05),the treatment group could significantly reduce UC Serum IL-6,IL-8 level (x2=8.314,P＜0.01); electronic colonoscopy examination points,hyperemia,erosions,ulcers in both groups were significantly improved,but the treatment group was significantly better than the control group (x2=8.322,P＜0.05) ; 6 months followed-up and the recurrence rate in treatment group were better than control group,and the difference was statistically significant (x2=5.857,P＜0.05).ConclusionThrough decreasing the IL-6,IL 8 levels,Kuiyu dection can treat ulcerative colitis,with significant effect,non-toxic side effects,inexpensive,and easy for use.

Objective:To investigate the occurrence and influencing factors of perioperative complications after robotic gynecologic surgery.Methods:The clinical data and occurrence of perioperative complications in 1 000 cases robotic surgery completed in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.Results:(1) Clinical data: the average age of the patients was (50.2±10.4) years old, and the average body mass index (BMI) was (24.4±3.6) kg/m 2. Among 1 000 cases, 811 cases of them were malignant tumors, including 405 cases of cervical cancer, 279 cases of endometrial carcinoma, 112 cases of epithelial ovarian cancer (EOC), 15 cases of vulvar cancer; 189 cases of them were benign diseases, including 43 cases of uterine prolapse, 57 cases hysterectomy of uterine leiomyoma and adenomyosis of the uterus ≥12 weeks, 84 cases myomectomy of uterine leiomyoma, and 5 cases of fallopian tubal ligation requiring anastomosis. Surgical methods: in patients with malignant tumors, cervical cancer, hysterectomy plus salpingectomy or salpingo-oophorectomy for stage Ⅰa1, and radical hysterectomy plus pelvic lymphatic dissection plus salpingectomy or salpingo-oophorectomy for stage Ⅰa2-Ⅱb. Endometrial carcinoma, performed by staging surgery. Staging surgery for EOC with early stage and cytoreductive surgery with advanced EOC. Vulvar cancer, extensive vulvar resection plus inguinal lymphadenectomy. In patients with benign diseases, uterine prolapse, hysterectomy plus salpingectomy or salpingo-oophorectomy plus sacrocolpopexy. Uterine leiomyoma or adenomyosis with uterus ≥ 12 weeks, hysterectomy plus salpingectomy or salpingo-oophorectomy. Myomectomy for patients requiring uterine preservation with uterine leiomyoma. Tubal anastomosis for patients with fallopian tubal ligation. (2) Surgical complications: intraoperative complications occurred in 25 patients (2.5%, 25/1 000), including 11 patients with vascular laceration, 11 patients with ureteral injury, 2 patients with bladder injury, and 1 patient with intestinal injury. Postoperative complications occurred in 130 patients (13.0%, 130/1 000), including 66 cases of lower limb venous thrombosis, 20 cases of lymphatic cyst, 8 cases of hydronephrosis, 9 cases of ileus, 16 cases with infection, 6 cases with genital fistula, 4 cases with trocar site herniation and 1 case with subcutaneous emphysema. The incidence of intraoperative complications was 3.1% (25/811) in malignant tumors and no case in benign diseases, the incidence rate in malignant tumors was significantly higher than that in benign diseases ( χ2=4.778, P=0.029). The incidence rate in cervical cancer (4.2%, 17/405) and EOC (3.6%, 4/112) were significantly higher than those in endometrial carcinoma (1.4%, 4/279) and vulvar cancer (0/15; P<0.05). The incidence of postoperative complications was 15.2% (123/811) in malignant tumors and 3.7% (7/189) in benign diseases. The incidence rate in malignant tumors was significantly higher than that in benign diseases ( χ2=17.807, P<0.01), but there were no significant difference among different malignant tumors ( χ2=4.318, P=0.229). (3) The correlative factors affecting the occurrence of surgical complications: patient′s age, BMI, previous pelvic or abdominal surgery history, the nature of disease (malignant or benign), operation time, and comorbidities had a significant impact on the incidence of postoperative complications ( P<0.05). Multivariate logistic regression analysis showed that the patient′s age ≥40 years old, BMI ≥25 kg/m 2, previous pelvic or abdominal surgery history, malignant tumors and comorbidities were independent influential factors of the postoperative complications ( P<0.05). Conclusions:Perioperative complications vary according to the type of the surgery. The age, BMI, previous pelvic or abdominal surgery history, malignant tumors, and comorbidities are influential factors of postoperative complications.

Objective:To investigate the feasibility and efficacy of Da Vinci robotic-assisted surgery in the early stage of ovarian cancer without inverted position.Method:s A retrospective chart review of the patients with early stage ovarian cancer was performed in the First Affiliated Hospital of Zhengzhou University from October 2014 to October 2018. Patients with early stage ovarian cancer underwent robotic-assisted surgical staging: 26 patients underwent the inverted position approach (inverted group) and 32 received the non-inverted position approach (no-inverted group). The operation time, intraoperative bleeding volume, the number of lymph nodes resection, post-operative anal exhaust time, the average hospitalization days and complications between two groups were compared.Result:s Surgeries were successfully performed between both groups. (1) The perioperative related indicators: the operation time and the postoperative anal exhaust time in the inverted group were significantly longer than those in the no-inverted group [(208±33) minutes vs (158±32) minutes, P<0.01; (2.6±0.5) days vs (2.1±0.8) days, P<0.01, respectively]. There were no significant differences (all P>0.05) in the intraoperative bleeding volume, the average hospitalization days and the number of lymph nodes resection. (2) The comparison of the incidence of surgical complications: there were no significant difference (χ 2=0.000, P>0.05) in the rate of lymphatic retention cyst [4% (1/26), 6% (2/32)]. Conclusions:Da Vinci robot system without inverted position in omentectomy is safe and feasible. Compared to the inverted position approach, it also provides remarkable advantages, including reduced operative time and faster return of bowel movement, but its long-term effects remain to be followed-up.

The management of healthcare services for the suspected cases in non-designated hospitalsis a serious concern in controlling coronavirus disease 2019 (COVID-19) epidemic. Owing to the complexity of care providers, large requirement of medical supplies as well as the possible needs off frequent transfers, the major difficulty is preventing the coronavirus from spreading while caring the suspected critical cases before the 2019 novel coronavirus ribonucleic acid test results are reported. For the purpose of enhancing the prevention of the propagation of COVID-19, this article puts emphasis on the following aspects in non-designated hospital Peking University Third Hospital: preparatory procedures of receiving critical suspected patients, the management of medical personnel during the waiting session of RNA test results, the delivering procedures of testing samples, the management of referred medical wastes, daily operations including the cleaning and sanitizing of caring units and the management of related patients after the testing session.

Objective:To investigate the ultrasonographic features and evolution of thyroid shrinking nodules in order to improve the differential diagnosis and management strategy and avoid unnecessary biopsy.Methods:A total of 245 patients with old bleeding of benign thyroid nodules diagnosed via fine needle aspiration cytology (FNAC) from May 2015 to July 2020 in the southern part of the Shanghai General Hospital Affiliated to the Medical College of Shanghai Jiaotong University, including 263 nodules. The sonographic parameters such as size, shape, aspect ratio, echo, edge, boundary, periphery, halo, calcification, posterior echo enhancement and posterior acoustic attenuation of nodules were analyzed retrospectively, and the ultrasonic appearances of nodules were classified; 41 nodules from 40 patients, who did ultrasound examinations more than twice and had both complete ultrasonographic data, were compared and then classified in order to explore the evolution rules of the nodules.Results:Two hundred and sixty-three thyroid shrinking nodules in 245 cases were classified into 4 types: "cystic wall shrinkage sign" type(71.48%, 188/263), "carcinoma-like" type (22.05%, 58/263), "inflammation-like" type(3.04%, 8/263) and "undefined atypical solid nodules" type(3.42%, 9/263). Of the 41 consecutive follow-up nodules, 37 cases showed obvious cystic wall shrinkage sign, and 7 of them developed into "carcinoma-like" type and 6 cases into "inflammation-like" type.Conclusions:The ultrasonographic appearance of thyroid shrinking nodules is a dynamic process, which can be divided into 4 types: "cystic wall shrinkage sign" , "carcinoma-like" , "inflammation-like" and "undefined atypical solid nodules" types. The "cystic wall shrinkage sign" type is typical and common. The "cystic wall shrinkage sign" type can develope into the "carcinoma-like" type or the "inflammation-like" type.

Objective: To evaluate the impact of bleomycin/etoposide/cisplatin (BEP) and paclitaxel/carboplatin (PC) chemotherapy regimens on the fertility and prognostic outcomes in malignant ovarian germ cell tumor (MOGCT) patients who underwent fertility-sparing surgery (FSS). Methods: A propensity score matching algorithm was performed between the BEP and PC groups. The χ2 test and the Kaplan-Meier method were used to compare the fertility outcome, disease-free survival (DFS) and overall survival (OS). The Cox proportional hazards regression analysis was used to identify risk factor of DFS. Results: We included 213 patients, 185 (86.9%) underwent BEP chemotherapy, and 28 (13.1%) underwent PC chemotherapy. The median age was 22 years (range, 8–44 years), and the median follow-up period was 63 months (range, 2–191 months). Fifty-one (29.3%) patients had a pregnancy plan, and 35 (85.4%) delivered successfully. In the before and after propensity score matching cohorts, there were no significant differences in spontaneous abortion, selective termination of pregnancy, during-pregnancy status, and live birth between the BEP and PC groups (p>0.05). Fourteen (6.6%) patients experienced recurrence, including 11 (5.9%) in the BEP group and 3 (10.7%) in the PC group. Four (1.9%) patients in the BEP group died. Kaplan-Meier analysis revealed no significant differences in DFS (p=0.328) and OS (p=0.446) between the BEP and PC groups, and the same survival results were observed in the after matching cohort. Conclusion The PC regimen is as safe as the BEP regimen for MOGCT patients with fertility preservation treatment, and no differences were observed in fertility and clinical prognosis.