Objective:To explore the relationship between the pathophysiological changes in TCM spleen de ciency syndromes and precancerous lesion of gastric mucosa.Method:160 cases with spleen de ciency syndromes accompanied by gastric mucosa intestinal metaplasia,IM and / or atypical hyperplasia,AHP,(spleen de ciency is divided into spleen qi de ciency or SQD,spleen yin de ciency or SyinD and spleen de ciency with qi stagnation or SDQS) and 22 cases in health control group were taken as the study object.The detection was conducted on such trace elements as Zn,Cu of gastric mucosa epithelial cell nuclei and mitochondrion under the direct view of CM200FEG –TEM by adopting 9100/60 -Energy Dispersion X-ray Analyzers;detection was conducted on epithelial cell nucleus DNA by using IBAS2000 image analyzer;detection was conducted on the expression of P53,Ki67,CerbB2,P21ras in gastric mucosa tissue slices by adopting ElivisionTM Plus'.Result:The quantitative changes of gastric mucosa epithelial cell nucleus DNA,Zn,Cu and the positive expression rates of P53,P21ras,CerbB2 and Ki67 increased in the sequence of SQD group,SyinD group and SDQS group,while mitochondrial Cu,Zn decreased in the same sequence,there was signi cant di erence between the groups(P

Objective To raise risk exposure awareness for spreading pathogenic microorganisms in anesthesia procedures and normalize aseptic technique of anesthesiologists,thus minimizing postoperative infection.Methods Choose 45 cases of general anesthesia.Respectively before anesthesia induction (Time0),five minutes after induction (Time1) and two hours after anesthesia (Time2),make bacteriological tests on seven spots vulnerable to contamination,including the three-way stopcock,screwtype hose coupling,oxygen flux knob,pressure-release valve surface,exhaled breath entry of the anesthesia machine,oxygen intake of the breathing loop of the anesthesia machine,and operating desktop of the anesthesia cart.Results Contamination risk exposure of the stopcock extends with the operative time.At Time 0,it is sterile; at Time 1,84.4％of the 45 cases are found with bacteria growth,with colony count of 1～2CFU/ml; at Time2,colony counts at various monitoring points range 7～21 CFU/ml,of which the differences between Timel group and Time0,as well as Time2 and Time0 are statistically significant(P＜0.05).Colony counts at other monitoring points comply with the regulations.Conclusion Three-way stopcocks are highly vulnerable to contamination during operative anesthesia.Regular sterile operations can effectively prevent and lower postoperative infection of the patients.

Objective To investigate the clinical value of bone metabolism biochemical marker N-MID,TP1NP and beta-CTx combined with whole body bone scintigraphy in early diagnosis of bone metastasis of tumor.Methods The concentration of the 3 markers were measured by the electrochemical luminescence analysis method in 30 cases of healthy control group and 210 cases of patients with malignant tumor,which were divided into non bone metastasis group(45 cases) and bone metastasis group(165 cases).The bone metastasis group were divided into 4 grades(0-grade Ⅲ) by Soloway classification according to whole body bone imaging.Results The levels of serum N-MID,TP1NP and beta-CTx in 165 malignant tumor patients with bone metastasis were significantly higher than in 45 malignant tumor patients with bone metastasis and in 30 healthy control group,the difference was statistically significant(P<0.05).With the increase of the number of metastatic lesions in the bone metastasis group,the serum levels of N-MID,TP1NP,and beta-CTx were increased gradually,and they were positively correlated with the progression of the disease.According to the analysis of ROC curve,the cut-off value,sensitivity and specificity in the diagnosis of tumor bone metastasis were 17.59 ng/mL,70.3％,88.9％ for serum N-MID,43.04 ng/mL,78.2％,95.6％ for TP1NP,and 0.48 ng/mL,73.9％,93.3％ for beta-CTx.Under the ROC curve(AUC) was 0.831 for serum N-MID,0.890 for TP1NP,and 0.869 for beta-CTx.The sensitivity and specificity of three bone metabolic markers in the diagnosis of bone metastasis of malignant tumor were significantly higher.Conclusion Bone metabolism biochemical markers:Serum N-MID,TP1NP and beta-CTx for diagnosis of bone metastasis of malignant tumor are sensitive,accurate and simple,which can significantly improve the efficiency of diagnosis of bone metastasis,and can be combined with whole-body bone scintigraphy in early diagnosis of bone metastasis with malignant tumor.

Objective:To explore the application of the mandarin Chinese version of the Leicester cough questionnaire (LCQ-MC) in the chronic disease management of adult patients with severe asthma.Methods:Thirty patients with severe asthma without a smoking history who received treatment and chronic disease management in the First Affiliated Hospital of Guangxi Medical University from December 2018 to December 2020 and met the inclusion criteria were selected as the research subjects. Their clinical symptoms, LCQ-MC, asthma control test (ACT), mini asthma quality of life questionnaire (MiniAQLQ), visual analogue scale (VAS) and lung function test were recorded. The reliability of LCQ-MC and its correlation with ACT, MiniAQLQ, VAS and lung function were analyzed.Results:Among the 30 patients, there were 14 males and 16 females, with an average age of (50.5±10.5) years old and a medical history of (38.3±15.5) years. The main manifestations were cough which was observed in 29 cases (96.7%), wheezing in 25 cases (83.3%), nasal symptoms in 14 cases (46.7%) and chest tightness in 11 cases (36.7%). All lung functions were consistent with the diagnosis of asthma. The total score of LCQ-MC was (16.1±4.2), in which the physiological, psychological and social dimensions were (5.0±1.2), (5.6±1.6), (5.5±1.7), respectively; and ACT (18.9+5.5), MiniAQLQ (4.9±1.4), VAS (33.5±32.4). The Cronbach′s α for the questionnaire was more than 0.70, and the results were positively correlated with ACT and MiniAQLQ ( r=0.553, 0.593, P=0.002, 0.001), negatively correlated with VAS ( r=-0.762, P<0.001). The correlations between LCQ-MC and these scores were consistent with the results after 6 months. Conclusion:Cough is an important symptom of severe asthma, and LCQ-MC can be effectively used for evaluation and chronic disease management of adult patients with severe asthma.

Objective To investigate the status and risk factors of surgical site infection (SSI)in hospitals in Chi-na,so as to provide theoretical basis for the prevention and treatment of SSI.Methods Four types of surgeries (colorectal surgery,abdominal hysterectomy,femoral neck repair surgery,and vascular surgery)in 29 hospitals were monitored prospectively,risk factors for SSI were analyzed.Results A total of 6 309 surgical procedures were investigated,incidence of SSI was 1 .60%.Incidences of SSI in patients receiving colorectal surgery,abdominal hys-terectomy,femoral neck repair surgery,and vascular surgery were 4.47%(74/1 655 ),1 .03%(22/2 139),0.21 %(5/2 372),and 0.00% (0/143 )respectively.The incidences of SSI were different among different regions (χ2 =114.213,P <0.05).The most common SSI was superficial incisional infection,the next was deep incisional infec-tion.The major pathogens causing SSI were Escherichia coli ,Enterococcus spp .,coagulase negative staphylococ-cus ,Staphylococcus aureus ,and Klebsiella pneumoniae .The independent risk factors for SSI were male patients, long duration of surgery,and high NNIS score.Conclusion The risk of SSI is varied with different types of surger-ies.Male,long duration of surgery,and high NNIS score can increase the risk of postoperative SSI.

Objective To explore the incidence of surgical site infection (SSI)and compliance to bundled interven-tion measures,and evaluate the effect of bundled interventions on controlling SSI.Methods From October 2013 to September 2014,three types of surgeries (colorectal surgery,abdominal hysterectomy,and femoral neck repair sur-gery)in 29 hospitals in China were monitored,October 2013 to March 2014 was baseline investigated stage,April 2014 to September 2014 was intervention stage.Results A total of 6 166 episodes of surgeries were monitored,the incidence of SSI was 1 .64%,incidence of SSI following colorectal surgery,abdominal hysterectomy,and femoral neck repair surgery were 4.47%,1 .03%,and 0.21 % respectively.The P 75 time of three types of surgeries were 3,2,and 2 hours respectively.Compared with the baseline stage,the compliance to most intervention measures im-proved after intervention,the largest increase in the compliance to interventions was disinfection with chlorhexidine-containing disinfectant at surgical sites of colorectal surgery (increased by 29.09%),followed by preoperative shower of femoral neck repair surgery (increased by 26.24%),preoperative shower of colorectal surgery(increased by 22.95%),and skin preparation on the day of operation (increased by 20.75%).Incidences of SSI in three types of surgeries were not significantly different before and after intervention(all P >0.05).Conclusion The incidences of SSI are different among different types of surgeries,the compliance to most bundled intervention measures has im-proved to some extent after intervention,but effectiveness of intervention measures needs to be further observed.

Objective To investigate the current health status of the targeted recipients of the precision poverty alleviation program in Taiziwan Village, Shazhenxi Town, Zigui County and explore its influencing factors, and to provide reference for the formulation of local health poverty alleviation policies. Methods A cluster sampling method was used to investigate 115 poverty alleviation recipients aged 18 and above in Taiziwan Village. The status of ^“physiological health^” and ^“mental health^” was investigated using the international general SF-36 (Chinese version) health scale. Results The survey subjects were mainly the people with advanced age, low education background and suffering from chronic diseases. Except for the physiological function score being more than 70 points, the scores of other dimensions were all 60 points around. The scores were 61.74±19.86 points for physical health and 59.05±16.91 points for mental health, respectively. People aged 60 and above scored lower in all dimensions than those aged under 60. Factors that affected both physical and mental health of the whole population were advanced age and chronic diseases. While the factors that affected physical health of people aged 60 and above were chronic diseases, the factors that affected mental health were chronic diseases and a long interval between children's home visits. Conclusion The health status of people aged 60 and above is worse than that of people aged below 60. Their physical health is affected by chronic diseases, and their mental health is affected by chronic diseases and children's visit cycles. While formulating poverty alleviation policies for physical health, an attention should also be paid to mental health.

Objective: Using three models too estimate excess mortality associated with influenza of Shanxi Province during 2013-2017. Methods: Mortality data and influenza surveillance data of 11 cities of Shanxi Province from the 2013-2014 through 2016-2017 were used to estimate influenza-associated all cause deaths, circulatory and respiratory deaths and respiratory deaths. Three models were used: (i) Serfling regression, (ii)Poisson regression, (iii)General line model. Results: The total reported death cases of all cause were 157 733, annual death cases of all cause were 39 433, among these cases, male cases 93 831 (59.50%), cases above 65 years old 123 931 (78.57%). Annual influenza-associated excess mortality, for all causes, circulatory and respiratory deaths, respiratory deaths were 8.62 deaths per 100 000, 6.33 deaths per 100 000 and 0.68 deaths per 100 000 estimated by Serfling model, respectively; and 21.30 deaths per 100 000, 16.89 deaths per 100 000 and 2.14 deaths per 100 000 estimated by General line model, respectively; and 21.76 deaths per 100 000, 17.03 deaths per 100 000 and 2.05 deaths per 100 000, estimated by Poisson model, respectively. Influenza-related excess mortality was higher in people over 75 years old; influenza-associated excess mortalityfor all causes, circulatory and respiratory deaths, respiratory deaths were 259.67 deaths per 100 000, 229.90 deaths per 100 000 and 32.63 deaths per 100 000, estimated by GLM model, respectively; and 269.49 deaths per 100 000, 233.69 deaths per 100 000 and 31.27 deaths per 100 000, estimated by Poisson model,respectively. Conclusion Excess mortality associated with influenza mainly caused by A (H3N2), Influenza caused the most associated death amongold people.