Community psychiatry is an important branch of psychiatry. This article introduced the concept of community psychiatry, the importance and necessity of setting up community psychiatry course in psychiatry , and the modern teaching methods in teaching community psychiatry course . Combined with the research results about knowledge and attitude of college students on mental illness and the teaching activity, the author further explalned the necessity of setting up community psychiatry in the teaching of undergraduate medical students, and put forward the problem-based learning and case teaching method to make it more easy for students to grasp and understand the knowledge points.

Establishment of combination of disease and syndrome animal model is an ideal technology platform in TCM research. Currently, many scholars have prepared matching IBS animal models combined typical animal models with etiology, which em-bodies the advantages of syndrome differentiation and promotes the development of combination disease and syndrome animal model. Even though, there still exists some problems about sub-jective evaluation on syndromes, paying more attention on dis-ease and less on syndromes. Therefore, we should deepen the pathogenesis of diseases and TCM syndromes research on animal model replication and improve the method of construction of combination of disease and syndrome animal model through the biological research of combination of disease and syndrome sys-tem. By this way, the idea of preparation animal models will be more mature and the scientific connotation of TCM will be pres-ented more exactly.

Objective To compare with the characteristics of different demographic and blood donation behaviors of the first blood donors and the repeated blood donors,to analyze the related factors influencing the repeated blood donation behavior,to provide the evidence to develop the recall strategy for the retention of the first-time donors strategies.Methods Use methods such as the composition ratio of descriptive analysis,and logistic regression analysis,Retrospectively analyzed the data of 3 226 571 cases of the whole blood donors in Zhejiang province from 2006 to 2015.from BIS2.0 Results ZheJiang repeated blood donors in 2006-2015 is accounted for 30.8％,men (57.8％),the proportion of aged 25 above is higher than the first blood donors;71.7％ of men in the repeated blood donors are 60-79 kg,52.2％ of women repeated blood donors are 50 to 59 kg;40％ of the repeat donors blood for the first time donate 400 mL;71.6％ of the repeated blood donors to donate again in 0.5-2 years,and of these,40.8％ back in 0.5-1 year.Conclusion The main factors on the demographic aspects that influence the repeated blood donation is occupation,cultural degree,the quantity of blood donation for the first time.The characteristics of the precise recall people are as follows:Age 26 to 45 years old,stable career,donate 400 mL for the first-time,weight 70-89 kg of male,weight 55 kg above of women.The better recall intervention Interval is preferred to 0.5-2 years,and 0.5-1 year is the best.

Objective To develop the PCR-denaturing high performance liquid chromatography (DHPLC) for detection of E. Coli O157: H7. Methods The virulence genes of Shiga-like toxin(SLT) and rfbE were specifically amplified by 2 sets of primers. The target gene fragments of the PCR assay were 224 bp and 499 bp, respectively. Results Analysis of 37 strains demonstrated that this PCR system was specific. The detection limit of the PCR was 4 CFU/ml. Conclusion These results indicated that the multiplex PCR-DHPLC assay can be used for specific and sensitive detection of E. Coli O157:H7.

Objective To discuss the effective methods to improve the teaching effect of Basis of Nursing and cultivation of high-quality persons. Methods We randomly divided 87 nursing students into the test group(42 eases) ,which adopt the combination of grouped scene teaching with role-playing teaching and the control group (45 cases),which received routine teaching methods.The effect of the two teaching methods was evaluated by questionnaires. Results The total score and the score of each section of the questionnaires in the test group were higher than those of the control group(P ＜ 0.05 ). Conclusions The combination of scene teaching with role-playing teaching could inspire students' interest,strengthen the role consciousness and improve their comprehensive quality.

Objective To compare the efficacy of different target concentrations of sufentanil target-controlled infusion used to supplement topical anesthesia for fiber-optic bronchoscopy (FOB)-assisted awake nasotracheal intubation in patients with obstructive sleep apnea syndrome (OSAS).Methods Forty-five ASA physical status Ⅱ or Ⅲ patients with OSAS,aged 28-60 yr,with body mass index of 30-40 kg/m2,scheduled for elective surgery,were randomly assigned into 3 groups (n =15 each):control group (group C) and sufentanil with the target plasma concentration of 0.4 ng/ml (group S1) and 0.6 ng/ml groups (group S2).Naso-pharyngeal and laryngeal mucous membrane was sprayed with 2％ lidocaine mixed with 1％ ephedrine for topical anesthesia in both groups.In addition 1％ tetracaine 3 ml was injected into trachea through cricothyroid membrane.FOB-assisted awake nasotracheal intubation was performed after the target concentration was achieved.The degree of airway obstruction was scored during intubation.The highest values of MAP and HR,rate-pressure product ＞ 12 000,decreased respiratory rate and hyoxemia were recorded during the period between induction of anesthesia and 3 min after intubation was completed.The changes in MAP and HR as percent of baseline values were calculated.Before topical anesthesia (T0),when target concentrations were reached (T1),and at 1 and 3 min after intubation (T2,3),blood samples were taken to determine the plasma concentrations of epinephrine (E),norepinephrine (NE) and cortisol.Results Compared with group C,the airway obstruction score was significantly decreased in group S1,the incidence of changes in MAP and HR ＞ 30％ of baseline values and rate-pressure product ＞ 12 000 was decreased,the plasma concentrations of E,NE and cortisol were decreased in S1 and S2 groups,and the incidence of the respiratory rate was decreased and hypoxemia was increased in group S2 (P ＜ 0.05).Compared with group S1,the airway obstruction score were significantly decreased,and the incidence of respiratory rate was decreased and hypoxemia was increased in group S2 (P ＜ 0.05).Compared with the baseline value at T0,the plasma concentrations of E,NE and cortisol were significantly increased at T2,3 in group C,while decreased at T1 in S1 and S2 groups (P ＜ 0.05).Conclusion Compared with pure topical anesthesia,sufentanil with the target plasma concentration of 0.4 ng/ml does not induce respiratory depression,maintains hemodynamics stable,attenuates the stress responses and provides better intubation conditions when used to supplement topical anesthesia for FOB-assisted awake nasotracheal intubation in patients with OSAS.

Objective:To investigate association between genetic polymorphism in the grainyhead-like 2 gene (GRHL2)and noise-induced hearing loss (NIHL)in the Chinese population.Methods:A matched case-control association study was employed,In which,3 790 workers exposed to continuous and steady-state occupational noise in a steel factory participated.The questionnaires were adopted to col-lect individual features and audiometry tests performed.In the sstudy,286 subjects were diagnosed as ca-ses,Which were each designated on the basis of the matched criterion,and 286 paired samples were se-lected finally.Noise intensity was measured according to the standards given in ‘Measurement of Noise in the Workplace’(Occupational Health Standard of the People’s Republic of China,GBZ /T1 89.8 -2007).Cumulative noise exposure (CNE)was calculated,according to monitoring data on A-weighed sound pressure level and employment time.Genomic DNA was obtained from peripheral blood samples using 2 mL DNA extraction Kit following the manufacturer’s protocol.Five single nucleotide polymor-phisms (SNPs)of GRHL2 were genotyped by multiplex SNP genotyping kit.The continuous variables and categorical variables were analyzed by t-test and chi-square test respectively.Multivariate Logistic re-gression was used to test the association between genetic frequency and disease status,with adjustments for the possible confounding variables.The haplotypes were established and their frequencies in the two groups were assessed by haploview and phase softwares.Results:All the five SNPs (rs373571 3, rs3824090,rs373571 4,rs373571 5 and rs61 1 41 9)were in Hardy-Weinberg equilibrium (HWE)(P >0.05).The subjects carrying rs373571 5 GG genotype had a higher NIHL risk than those carrying the GA genotype under the co-dominant model (OR =0.644,95% CI:0.442 -0.939,P =0.022)after ad-justment for height,blood pressure,drinking status and smoking status.After being stratified by CNE,in the CNE ≥ 98 dB (A)group,rs373571 5 polymorphism was associated with the NIHL under the co-dominant model (OR =0.509,95% CI:0.281 -0.923,P =0.026)after adjustment for height,blood pressure,drinking status and smoking status as well.However,no statistical significant difference was found in variant genotypes of the other SNPs between the case and control subjects.Four-locus (rs373571 3,rs3824090,rs373571 4 and rs373571 5)haplotypes were constructed,and no risk or protec-tive haplotypes was identified.Conclusion:It is suggested that GRHL2 polymorphisms may be associated with development of NIHL.

Objective To discuss the technical points and the clinical application of single wire-guided inverted Y-shaped tracheal stent implantation under general anesthesia in treating complex tracheal diseases. Methods During the period from January 2014 to October 2014 at authors’ hospital, a total of 6 patients with complex tracheal diseases received inverted Y-shaped tracheal stent implantation. The diseases included trachea-pleural fistula(n=1), trachea-esophageal fistula(n=2) and complex tracheal stenosis(n=3). Under general anesthesia and guided by DSA, inverted Y-shaped tracheal stent implantation was carried out in all the 6 patients. The results were analyzed. Results A total of 6 Y-shaped tracheal stents were used in the 6 patients, and single wire-guided implantation technique was employed in all procedures. In one case , the right branch of the Y-shaped tracheal stent was placed in the right upper lobe bronchus by mistake , and in the remaining 5 cases the stent implantation was successfully accomplished with single manipulation. Conclusion Under general anesthesia, Y-shaped tracheal stent implantation can effectively obstruct the trachea-pleural fistula and left main bronchus-esophageal fistula, and it can also quickly and significantly relieve the complex airway stenosis located at the tracheal carina region. This treatment is safe and reliable with satisfactory short-term effect. Moreover, single wire-guided manipulation is technically simpler, easier and faster than dual wire-guided manipulation. Therefore, this technique should be recommended in the clinical practice.

Objective:To systematically evaluate and integrate the qualitative research of nursing students participating in hospice care practice experience, to provide a basis for the better development of hospice care education.Methods:A computer search was conducted on the China national knowledge infrastructure, Chinese Biomedical Literature Database, VIP database, Wanfang Medical Database, Cochrane Library, Embase, Web of Science, and PubMed for qualitative research on nursing students' participation in hospice care practices. The search period was from the establishment of the database to February 2023. The quality of the included literature was evaluated using the qualitative research quality evaluation criteria of the Australian JBI Evidence Based Health Care Center. A aggregative integration method was used for result integration.Results:A total of 16 articles were included, and 46 major research results were extracted and summarized into 9 new categories, forming 4 integrated results: providing hospice care services for patients and their families; emotional experience of nursing dying patients; coping with negative experience and harvesting personal growth; needs and difficulties.Conclusions:Nursing students experience multiple emotional experiences in hospice care practice, and are eager to help and support in various aspects. It is suggested for managers to pay attention to the inner experience and needs of nursing students, improve hospice care education in China, and improve the end-of-life care ability of nursing students.

Objective:To systematically review the experience of nurses′ in providing home-based hospice care, so as to provide a basis for improving the quality of home-based hospice care and the nursing service system.Methods:Qualitative researches on nurses′ experience of providing home-based hospice care were retrieved from the Cochrane Library, PubMed,Web of Science, EBSCO, Medline, China National Knowledge Internet, China Biomedical Literature Database, Wanfang Database, VIP Database from inception to April 1, 2022. Adopting Joanna Briggs Institute Critical Appraisal Tool (2016) to evaluate the quality of included studies, the Meta-synthesis was used to explain and integrate the research results.Results:A total of 9 articles were included. This study extracted 23 clear results, 8 new categories, and 3 integrated results, including the significance of nurses′ acceptance of home-based hospice care; positive and negative emotions coexist when nurses provide home-based hospice care; challenges in implementing home-based hospice care.Conclusions:The development of home-based hospice care service is helpful to provide continuous care for the terminally ill patients and improve their quality of life, but at the same time, the ability of home-based hospice care of nurses should be further improved and the related policy guarantee should be perfected to promote the steady development of home-based hospice care in China.