Objective To understand the basic medical and health personnel's perception of fairness for pay for performance program .Methods This study used document analysis , expert consultation , pre-survey method to de-sign the questionnaire , and then was conducted on 367 medical and health personnel at the basic level in Zhejiang Prov-ince, analysis of variance , correlation analysis were used for statistical analysis .Results Only 0.13% of the basic medical and health personnel think pay for performance program is very fair;23.16%of people think pay for perform-ance program is fair;29.43%of people do not know whether pay for performance program is fair;34.06%of people think pay for performance program is not fair;11.99% of people think pay for performance program is very unfair . There were no significant differences between age , educational levels, working time, professional qualifications and po-sition(p>0.05).Staff in different areas of the perception of pay -for-performance fairness exists obvious difference (p<0.05).Conclusion Only a small portion of basic medical and health personnel think pay for performance pro -gram is fair, and it may directly affect the enthusiasm of staff , reduce the work quality and efficiency of basic medical and health personnel .It suggests that relevant departments should improve the pay for performance program .

Objective To study the influence of anesthesia methoda on early postoperative cognitive function in elder orthopedics patients. Methods Fifty patients aged more than 65 years old with fractured femur randomly received general anesthesia(group G, 28 cases) or unilateral combined spinal epidural anesthesia(group E,22 cases). The assessment of postoperative cognitive {unction referred to the scores that achieved in neuropsychological testing with mini mental state examination (MMSE) by special psychological person on the day before and the first day after surgery. It was considered to he postoperative cognitive dysfunction (POCD) when the score was ≥1 standard deviation(SD). Results The score of MMSE was lower in group G than that in group E on the first day alter surgery(P<0. 05). The incidence of POCD on the first day after surgery was higher in group G than that in group E(42.9% vs. 13. 6%) (P<0. 05). Conclusion Compared to combined spinal epidural anesthesia, more POCD takes place in the eldedy underwent orthopedic surgery under general anesthesia.

Objective To study changes of telomerase activity in transitional cell carcinoma after intravesical instillation of Serratia Marcescens . Methods TRAP-PCR and TRAP-sliver staining were used to detect telomerase activity in 20 patients with TCC after intravesical instillation of Serratia Marcescens . Results Positive rate of telomerase activity detection in TCC patients after intravesical instillation of Serratia Marcescens was 50%(10/20),significantly lowed than before the intravesical instillation (90%,18/20), P

model rats group. Conclusion Bushenhuoluofang increased the weight of ovary and uterus, follicular number and endomelrium area of ASR. By affecting the level of FSH and LH of the rat, improves its endocrine function and the growth of follicle, Bushenhuoluofang achieved the purpose of promoting ovulation.

Objective The purpose of this study was to determine the value of K-ras mutation in DNA extracted from the plasma as clinical indicator of colorectal cancer. Methods Point mutation at codon 12 of K-ras gene was assayed by polymerase chain reaction of sequence-specific primers in DNA extracted from the plasma and tumors from 32 patients with colorectal cancer. The mutation was further confirmed by dideoxy-mediated chain-termination method of DNA sequencing. Results Fourteen patients (44%) had a codon 12 K-ras mutation within their primary tumors and identical mutations were found in the plasma DNA of 13 patients (93%). Mutant DNA was not detected in the plasma specimens of 18 patients whose tumors tested negative for K-ras alterations or in 5 healthy control subjects. Conclusion Preliminary results suggest the detection of K-ras mutations in circulating DNA extracted from the plasma specimens may have some clinical uti- lity in the detection of colorectal cancer.

Objective: To construct air quality health index (AQHI) in Jinhua City, Zhejiang Province based on the exposure-response relationship between air pollutants and years of life lost (YLL), and evaluate the health risk associated with air quality. Methods: Air pollutants and meteorological data in Jindong District and Wucheng District of Jinhua City from 2014 to 2021 were collected through Jinhua Environmental Monitoring Center and Jinhua Meteorological Bureau. Non-accidental death data of residents during the same period was collected through Zhejiang Chronic Disease Monitoring Information Management System. The exposure-response relationship between major air pollutants and YLL was analyzed using a generalized additive model (GAM), and major pollutants were screened for calculating AQHI. The exposure-response relationship between AQHI and YLL was analyzed using GAM. Results: The results of single-pollutant model analysis showed that the lagged effect of PM2.5 on YLL was the largest at lag of 1 day, and the effect of SO2 on YLL was the largest on the same day. The results of dual-pollutant model analysis showed that the impact of PM2.5 on YLL was statistically significant when other pollutants were included at a lag of 1 day, and the impact of SO2 on YLL was statistically significant when NO2 was included on the same day (all P<0.05). The average daily mass concentration of O3 exceeded the standard by a relatively high rate of 42.27% from 2014 to 2021. Based on the analysis results of single-pollutant and two-pollutant models, excessive pollutant condition and relevant research findings, PM2.5, SO2, NO2 and O3 were selected as the major pollutants for calculating the AQHI. The median AQHI value of 1.40 (interquartile range, 1.13) from 2014 to 2021. According to the AQHI classification standard, 94.55% was the time was at low risk, and 4.93% of the time was at medium risk. With an increase in AQHI by one interquartile range, the YLL among the entire population, males, females, <65-year-old and ≥65-year-old populations would increase 6.21, 3.26, 6.46, 4.24 and 10.57 person-years, respectively. Conclusions The air quality health risk in Jinhua City was low at most of the time from 2014 to 2021. An increase in AQHI was associated with an increased risk of YLL among population.

Objective: To explore the effects of short-term exposure to four air pollutants, namely fine particulate matter (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2) and ozone (O3), on death and years of life lost (YLL). Methods: Air pollutants and meteorological data in Jindong District and Wucheng District of Jinhua City, Zhejiang Province from 2014 to 2021 were collected through Jinhua Environmental Monitoring Center and Jinhua Meteorological Bureau. Death data of residents during the same period was collected through Zhejiang Province Chronic Disease Monitoring Information Management System. The effects of short-term exposure to four air pollutants on death and YLL were analyzed using a generalized additive model. Results: The results of single-pollutant model analysis showed that the lagged effect of short-term exposure to PM2.5 on death and YLL was the largest at cumulative lags of 2 days, with effect size of 1.064% (95%CI: 0.450%-1.682%) and 2.084 (95%CI: 1.003-3.165) person-years, respectively; the effect of short-term exposure to SO2 on YLL was the largest on the same day, with an effect size of 2.432 (95%CI: 0.610-4.254) person-years; short-term exposure to NO2 and O3 had no statistically significant effects on death and YLL (both P>0.05). The results of gender- and age-stratified analysis showed that short-term exposure to PM2.5 had significant lagged effects on death and YLL among females and residents aged 65 years and above at cumulative lags of 2 days; short-term exposure to SO2 had significant effects on YLL among females and residents aged 65 years and above on the same day (both P<0.05). The results of dual-pollutant model analysis showed that after the inclusion of NO2 in PM2.5 and SO2, the effects on death and YLL were statistically significant, with the effect size being higher compared to the single-pollutant model; after the inclusion of SO2 or O3 in PM2.5, the effects on death and YLL were statistically significant, with the effect size being lower compared to the single-pollutant model (all P<0.05). Conclusion Short-term exposure to PM2.5 may increase the risk of death and YLL, and short-term exposure to SO2 may increase the risk of YLL among residents, with more significant impacts on female and residents aged 65 years and above.

Objective: To investigate the prevalence and influencing factors of work-related musculoskeletal disorders (WMSDs) in neck and shoulder among workers in pharmaceutical and chemical enterprises, so as to provide the basis for prevention of WMSDs. Methods: Workers in 8 pharmaceutical and chemical enterprises in Jinhua City, Zhejiang Province from July to October 2023 were sampled using a stratified random sampling method, and demography, work conditions and WMSDs prevalence were collected using questionnaire surveys. Factors affecting WMSDs in neck and shoulder were analyzed using a multivariable logistic regression model. Results: A total of 1 343 workers were surveyed, including 496 males (36.93%) and 847 females (63.07%). The mean age of workers was 38 (15) years, and the length of service in current posts was 6 (8) years. There were 356 workers with WMSDs (26.51%), with 206 workers with neck WMSDs (15.34%) and 167 workers with shoulder WMSDs (12.43%). Multivariable logistic regression analysis showed that gender (female, OR=1.692, 95%CI: 1.203-2.381), sufficient rest time (OR=0.660, 95%CI: 0.471-0.926) and maintaining same neck posture for a long time (OR=1.690, 95%CI: 1.148-2.510) were factors affecting neck WMSDs; gender (female, OR=1.572, 95%CI: 1.060-2.311), sufficient rest time (OR=0.619, 95%CI: 0.422-0.906), repetitive daily work (OR=1.678, 95%CI: 1.064-2.647), uncomfortable work posture (OR=3.791, 95%CI: 1.330-10.803), multiple repetitive movements per minute (OR: 1.988-2.413, 95%CI: 1.060-4.161) and maintaining same neck posture for a long time (OR=1.926, 95%CI: 1.218-3.043) were factors affecting shoulder WMSDs. Conclusion The prevalence of WMSDs in neck and shoulder are high among workers in pharmaceutical and chemical enterprises in Jinhua City, and mainly affected by gender, rest time and adverse ergonomics.

Objective: To investigate the quality of life among patients with occupational pneumoconiosis in Jinhua City, Zhejiang Province, so as to provide insights into improving the quality of life among patients with occupational pneumoconiosis. Methods: Patients with occupational pneumoconiosis in Jinhua City from 2009 to 2021 were retrieved from the National Occupational Disease and Health Risk Factors Monitoring Information System. Participants' demographics, diagnosis of pneumoconiosis, stage of pneumoconiosis, pulmonary function and medical expense were collected through questionnaire surveys, and the quality of life was measured using a Chinese version of the Short-Form Health Survey (SF-36). The quality of life was descriptively analyzed among patients with occupational pneumoconiosis by disease stage, pulmonary function, expense for disease diagnosis and treatment and educational level. Results: A total of 244 patients with occupational pneumoconiosis were enrolled, including 225 men (92.21%). The participants had a mean age of (75.20±9.42) years, and mean duration from dust contact to pneumoconiosis onset of (13.11±9.89) years. The scores for physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health were (64.03±31.22), (45.14±44.22), (56.34±26.60), (40.80±19.80), (59.14±17.35), (68.41±19.67), (47.03±44.08) and (61.15±17.06) points among patients with occupational pneumoconiosis, which were all lower than the national constant (P<0.05). Lower scores were measured for physical functioning [(31.17±23.40) points], bodily pain [(45.21±19.50) points] and vitality [(47.00±20.70) points] among patients with stage Ⅲ occupational pneumoconiosis, for physical functioning [(32.27±24.24) points], role-physical [(12.88±30.70) points], bodily pain [(37.44±20.43) points], general health [(14.76±17.17) points], vitality [(38.79±19.33) points], social functioning [(53.33±17.08) points], role-emotional [(9.09±26.71) points], and mental health [(53.21±17.25) points] among occupational pneumoconiosis patients with severe pulmonary function damages, and for physical functioning [(30.97±27.40) points], bodily pain [(37.77±24.34) points], general health [(19.10±18.62) points], vitality [(38.39±23.78) points], social functioning [(55.89±21.00) points] and mental health [(55.35±20.35) points] among occupational pneumoconiosis patients that had personal payments for pneumoconiosis diagnosis and treatment expenses exceeding 30% of annual household incomes, while higher scores were measured for physical functioning [(66.36±17.33) points] and role-physical [(59.09±45.10) points] among occupational pneumoconiosis patients with an educational level of high school and above (all P<0.05). Conclusions The quality of life was low among occupational pneumoconiosis patients in Jinhua City from 2009 to 2021. Stage of pneumoconiosis, pulmonary function, medical expenses and educational level were identified as factors affecting the quality of life among occupational pneumoconiosis patients in Jinhua City.

Objective: To investigate the disease burden of occupational pneumoconiosis from 2009 to 2021 in Jinhua City, Zhejiang Province, so as to provide insights into formulating occupational pneumoconiosis prevention and control measures. Methods: Data on occupational pneumoconiosis in Jinhua City from 2009 to 2021 were collected through Occupational Disease and Health Hazard Monitoring Information System including demographic characteristics, disability level, age, pneumoconiosis type and stage, and analyzed years live dwith disability (YLD), years of life lost (YLL) and disability adjusted life years (DALY) by different genders, pneumoconiosis stages, pneumoconiosis types, ages and disability levels. Results: A total of 244 occupational pneumoconiosis cases were diagnosed in Jinhua City from 2009 to 2021, of which 225 cases were male, accounting for 92.21%. The median age of onset was 44.50 (interquartile range, 23.00) years. There were 229 deaths, with a median age of 78.00 (interquartile range, 13.00) years. The DALY was 3 791.88 person-years, YLD was 2 428.21 person-years (64.04%) and YLL was 1 363.67 person-years (35.96%). The YLD was 3 647.8 person-years in men, which was higher than 144.08 person-years in women (P<0.05). The YLD of asbestosis cases was lower than that of silicosis, coal workers' pneumoconiosis and other pneumoconiosis (P<0.05). The YLL was not statistically significant in the stage and type of occupational pneumoconiosis (P>0.05). The YLD was higher among cases at ages of less than 40 years, and lower among cases at ages of 60 to 69 years and 70 years and over (P<0.05); the YLL was lower among cases at ages of 70 years and over (P<0.05). The cases with second/third level of disability had the highest YLD, followed by the cases with fourth/fifth level of disability, and the cases with sixth/seventh level of disability had the lowest YLD (P<0.05). Conclusions The disease burden of occupational pneumoconiosis in Jinhua City from 2009 to 2021 is mainly induced by disability, and the disease burden caused by silicosis is the highest. With the progress of pneumoconiosis stages and disability levels, the life loss continues to increase.