Objective To understand the vision functioning related quality of life in rural residents of Shanxi province,and explore its related factors.Methods By using a multi-stage stratified cluster sampling method,237 rural residents from four township of Shanxi Province were conducted a questionnaire survey of vision functioning related quality of life.Using single factor and multiple factor regression model,the factors related to vision functioning related quality of life were explored.Results There were effective survey of 223 people,including 65 males (29.10％) and 158 females (70.9％).The age of residents was (35.8 ±14.2) years old.As the three aspects of vision functioning related quality of life (general health and vision acuity,grades of activity disabilities,reflections of vision problems) scores were 70.87 ± 17.19,91.56 ±9.13,85.20 ± 19.73 respectively.The visual functioning of general health and visual acuity scores and ophthalmic use and ocular history was negatively correlated; grades of activity disabilities scores and family history and history of drug was negatively correlated; reflections of vision problems scores were negatively correlated with age,but positivley related with mental state.Conclusion Vision functioning related quality of life is related with multiple factors,including age,ophthalmic use,ocular history,medication history,family history of ocular disease,and state of mind can affect vision functioning related quality of life score.Health education need strengthen to the residents according to the actual situation.

Traditional Chinese medicine placebo has been put more and more attention to. However, there is no ac-cepted quality evaluation method for TCM placebo. How to evaluate TCM placebo objectively and quantitatively is a common problem in the industry of Chinese medicine. New technologies such as the Intelligent Sensory Technique have been used to establish the placebo evaluation methods which are suitable for TCM characteristics. This article provided the basis for establishing scientific, rational and objective evaluation guiding principles for TCM.

Objective To understand environmental quality status of clean operating rooms in municipal hospitals of Xi’an,and provide reference for ensuring the clean quality of operating rooms.Methods On-site specimen collec-tion and detection were conducted to detect and analyze the cleanlinss of air in clean operating rooms in 15 hospital of Xi’an.Results A total of 51 operating rooms were monitored,secondary and tertiary hospitals had 24 and 27 operating rooms respectively;26 were grade-I and 25 were grade-Ⅲ operating rooms.The qualified rates of dust particle≥0.5μm/particle size in grade-I and grade-Ⅲ clean operating rooms were 76.92% and 80.00% respective-ly,≥5μm/ particle size were 73.08% and 88.00% respectively.The qualified rates of dust particle counts in grade-I and grade-Ⅲ clean operating rooms were 61 .54% and 80.00% respectively,difference was not significant(χ2=2.092,P >0.05 ).The qualified rate of dust particle counts in clean operating rooms in tertiary hospitals was significantly higher than secondary hospitals(85.19% vs 58.33%,χ2 =4.600,P <0.05 ).The qualified rates of airborne microbes in operating zone of secondary and tertiary hospitals were 87.50% and 92.59% respectively(P >0.05),in surrounding zone were 95.83% and 92.59% respectively (both P >0.05).Conclusion Dust particle and airborne microbes in some clean operating rooms in municipal hospitals of Xi’an are beyond the standard,supervi-sion and management should be strengthened.

Objective To reveal the role of serum ACE2/Ang (1-7)in the occurrence of atrial fibrillation (AF)and find new targets for the prevention and treatment of AF by analyzing the correlation between the serum concentration of ACE2/Ang (1-7 )in patients with rheumatic valvular heart disease and the occurrence of AF. Methods We collected the basic clinical information and peripheral venous blood of patients with rheumatic heart valve disease (totally 46 patients,including 24 with AF and 22 with SR).ELISA method was used to detect the serum concentration of ACE2,Ang (1-7)and AngⅡ in the serum samples.Then the differences and correlation between the two groups were analyzed.Results In the AF group ① the diameter of the left atrium was significantly greater than that in the SR group [(60.70±3.08 vs.48.15±2.16)mm,P<0.05];② the serum concentration of AngⅡ was significantly higher than that in the SR group [(45.88±2.87 vs.35.78±1.08)pg/mL, P<0.05],AngⅡ and left atrium diameter were positively correlated (Pearson test,P<0.05);③ the serum concentrations of ACE2 [(7.87±0.74 vs.11.65±0.57)U/L,P<0.05]and Ang (1-7)[(146.05±17.61 vs. 321.71±36.50)pg/mL,P<0.05]were significantly lower than those in the SR group,and negatively correlated with left atrium diameter (Pearson test,P<0.05);④ the serum concentration of Ang (1-7)was negatively correlated with AngⅡ concentration (Pearson test,P<0.05).Conclusion For patients with rheumatic valvular heart disease,ACE2/Ang (1-7 )may play a protective role in the occurrence of AF via antagonizing AngⅡ and inhibiting atrial remodeling.

Objective To understand the current situation of pressure steam sterilization in medical institutions in Xi'an city,and provide reference for the monitoring and quality control of pressure steam sterilization.Methods Central sterile supply departments(CSSDs) in medical institutions in Xi'an in 2012-2014 were investigated.Physical,chemical,and biological monitoring methods were used to evaluate the pressure steam sterilizers.Results A total of 135 medical institutions in Xi' an were monitored,including 40 tertiary medical institutions and 95 secondary and below medical institutions.A total of 540 specimens were collected,454 were qualified,overall qualified rate was 84.07 ％.Qualified rate of monitoring result of pressure steam sterilization of tertiary medical institutions was higher than secondary and below medical institutions(93.13 ％ vs 80.26 ％,x2 =13.91,P＜0.01).Qualified rates of chemical PCD and biological test pack of tertiary as well as secondary and below medical institutions were 100％ and ＞90％ respectively.The qualified rate of recoded temperature in secondary and below medical institutions was 88.42 ％,but actually measured temperature was 38.95 ％,which was significantly lower than 72.50 ％ of tertiary medical institutions(x2 =12.68,P＜0.01).The rates of the measured temperature＞ 134℃ of pressure steam sterilizer in each year were all low,but measured temperature＜132℃ was about 50.00 ％,difference between actually measured temperature and recorded temperature was-4℃-1 ℃,difference between-2.5 ℃-0.5℃ accounted for 80.00％,the main unqualified temperature was 130℃-131 ℃,accounting for 82.61 ％.Conclusion Efficacy of pressure steam sterilization is different in different levels of medical institutions in Xi'an,physical monitoring measures are not standardized,the supervision of physical parameters in key sectors should be strengthened to ensure the sterilization quality of medical institutions and reduce the occurrence of iatrogenic infection.

Objective To investigate the current status of hand hygiene(HH) among health care workers(HCWs) in clinical laboratories in medical institutions in Xi'an City.Methods HH status of HCWs in clinical laboratories in medical institutions in Xi'an was performed random on-the-spot sampling and monitoring.Results A total of 240 HH specimens of HCWs in clinical laboratories in 80 medical institutions in Xi'an City were collected, 127 detected results were qualified, the total qualified rate was 52.92%.The qualified rates of medical institutions were as follows: municipal hospitals 62.67%,workers' hospitals 55.95%,private hospitals 40.74%;comprehensive medical institutions 67.68%,specialized medical institutions 42.55%;tertiary medical institutions 79.63%(n=43),secondary and below medical institutions 45.16%(n=84),there were significant differences in HH qualified rate among HCWs in different types of medical institutions(all P<0.01).Of different HH detection items, detection rates of Escherichia coli and Staphylococcus aureus were 0.83% and 8.33% respectively.There were significant differences in HH compliance rates among HCWs of all age groups(χ2=9.103,P<0.05), HCWs aged≥50 years had the highest qualified rate of HH(71.43%), followed by those aged<30 years (67.82%),HCWs in 40~ year age group had the lowest HH qualified rate (39.66%).Conclusion The qualified rate of HH of HCWs in clinical laboratory of medical institutions in Xi'an City is low, it is necessary to enhance the procaution awareness of HCWs in clinical laboratories, strengthen quality control of HH, strictly implement standard hand-washing procedures to reduce occurrence of HAI.

Objective:To study the incidence and risk factors of the corrected QT (QTc) prolongation in breast cancer patients treated with anthracyclines.Methods:From July 2017 to January 2019, 279 female breast cancer patients who underwent 4 cycles of anthracycline treatment in Department of Breast Surgery of the People′s Hospital of Shanxi Medical University were enrolled in the study. The ECG of all patients before treatment showed sinus rhythm and QTc<440 ms. The most common electrocardiographic abnormalities after treatment were the changes of QTc. There were 78 cases with prolonged QTc (≥440 ms, QTc prolongation group) and 201 cases with normal QTc (<440 ms, non-prolongation group). The risk factors of QTc prolongation were analyzed by univariate and multivariate logistic regression. Cardiac toxicity was evaluated according to clinical symptoms and ECG results during treatment.Results:The common ECG abnormalities after treatment were 78 cases of QTc prolongation (28.0%), 22 cases of ST-T changes (7.9%), and 18 cases of sinus bradycardia (6.5%). Univariate analysis showed that there were significant differences in administration of anthracyclines(contained epirubicin in 48 and 73 cases, pirubicin in 10 and 33 cases, doxorubicin in 4 and 12 cases, liposomal doxorubincin in 16 and 83 cases,χ 2=15.54, P<0.01), dexrazoxane use (χ 2=5.43, P=0.02), coronary heart disease (χ 2=4.56, P=0.03), obesity or overweight (χ 2=4.51, P=0.03) between two groups. Multivariate logistic regression analysis showed that the use of different types of anthracyclines ( OR=1.42, 95 %CI: 1.37-1.48, P=0.02) and overweight/obesity ( OR=1.23, 95 %CI: 1.16-1.30, P=0.04) were independent risk facors of QTc prolongation. The liposomal doxorubicin in anthracyclines resulted in a minimum incidence of the QTc prolongation (16.2%, 16/99), while that of epirubicin was up to 39.7% (48/121). Preventive use of dexrazoxane reduced the incidence of the QTc prolongation to 11.4% (4/35). The incidence of the QTc prolongation in breast cancer with coronary heart disease or overweight/obesity was relatively high, which was 4/6 and 34.4%(42/122), respectively. No cardiotoxic symptoms such as chest pain, palpitation and shortness of breath occurred during the treatment, and no fatal arrhythmia such as ventricular tachycardia and ventricular fibrillation was observed in electrocardiogram. Conclusion:Although the incidence of the QTc prolongation in breast cancer patients treated with anthracyclines is high, there is no serious cardiotoxicity such as fatal arrhythmia. Breast cancer patients with coronary heart disease or overweight/obesity are more likely to have the QTc prolongation. Preventive use of dextrazoxan or the selection of liposomal doxorubicin can reduce the incidence of the QTc prolongation.

Objective To explore rotating nursing students′ feelings and experience of patients′postoperative prone position during their practice in department of ophthalmic surgery, so as to make them more considerate about the patients′ pain and difficulty out of transference, more patient to the patients, and thus increase patients′ comfort and satisfaction. Methods Hermeneutic phenomenological method in qualitative research was adopted. Every rotating nursing student, during the rotation, spent 40 min experiencing the prone position, and 12 were interviewed fully by researchers about their actual feelings and thoughts. Results With generic analysis, after repeated introspection, comparison and induction, four major themes were extracted:comfort level of the prone position was lower than expected; existing prone position equipments needed to be improved; nursing students were lack of patience to the prone-position patients; clinical teaching methods of nursing needed to be improved. Conclusions By experiential teaching, nursing students are fully aware of the discomfort of prone position and shortcomings of equipments, which help them to be more empathetic and more patient to the patients.

Objective To explore the influence of "321" health education model on the quality of life, physiological and psychological treatment and uncertainty of disease in patients with diabetic retinopathy. Methods From January to December 2016, 104 patients with fundus surgery in the hospital for the treatment of diabetic retinopathy were selected as the research object. They were randomly divided into observation group and control group by the random number table method. Patients in the control group received routine health education and the patients in the observation group received the "321" model of health education. Patients in the two groups were tested with Mishel's uncertainty in illness scale (MUIS) before and after receiving education. The uncertainty of disease between two groups before and after education was compared, and two groups were assessed by using SF-36 scale and diabetes specific quality of life (DSQL). Results Before the education, the scores of disease uncertainty in the control group and the observation group were (104.9±6.7) and (105.1±6.5) points, and the difference was not statistically significant (t=-0.154, P=0.878); After receiving education, the scores of disease uncertainty in the control group and the observation group were (92.6±6.2) and (82.2±6.1) points, and the difference was statistically significant (t=8.622,P< 0.001); The scores of psychological/mental health and treatment were significantly different between the two groups after receiving education (P<0.05). Conclusions The "321" health education model for diabetic retinopathy can significantly reduce the uncertainty of disease, and has positive significance for the psychological/mental health and treatment of the patients.

Objective To investigate the growth pattern of rural Tibetan children in the first year after birth.Methods In rural area of Lhasa,Tibet,252 subjects were recruited and their weight,length were measured longitudinally from birth to 12th months of age.Frequency of monitoring reached 5 times in total and Ponderal index (PI) was calculated for each visit.Mixed model was used to analyze the changes of length and weight by gender after controlling for birth weight.Results Birth weight and length showed great influence on children' s growth (weight:β =-0.681 9,P＜0.000 1,length:β =-0.957 1,P＜0.000 1).Weight and length of Tibetan male infants at each age point were lower than WHO new standard on growth and the Reference from 2005 National Survey on growth of children in China.The gap seemed widened by time but the gap between Tibetan female infants and Chinese standard narrowed 6 months after birth.Data showed that the higher PI of Tibetan infants than that of other Chinese infants which might infer that Tibetan infants had a more solid body mass under their own height.Conclusion The growth pattern of Tibetan infants might have its own feature.Tibetan infants appeared to have had higher PI,which was contradictory to the general conclusion that poor growth and development status had been seen in Tibetan children.