Enterovirus 71 (EV71) is a member of the Entero-virus genus of the Picornaviridae family and is the major cause of Hand,foot,and mouth disease (HFMD) in children.Different strains from Gansu were cloned and the P1 protein was sequenced and analysed.Results indicate that there are three kinds of EV71 infections prevalent in Gansu.The VP1 protein from one of these strains,55F,was expressed.The recombinant protein was expressed with high level and reacted specifically with the EV71 patient antibody,the recombinant protein was also applied to raise antiserum in rabbits and after the fourth injection a high titer of antiserum was detected by ELISA assay.These data are useful for further clarification of prevalent EV71 strains in the north of China at the molecular level and provide a basis for EV71 diagnosis.

Hyponatremia is the most common electrolyte abnormality in cancer patients, which is usually related to the syndromes of inappropriate antidiuretic hormone secretion (SIADH). Despite not frequent life-threatening, it mostly causes prolonged hospitalization, delaying in scheduled chemotherapy, reducing of the efficacy, worsening of patients' prognosis and quality of life. The optimal treatment strategy should be chosen based on the severity and the onset time of the symptoms in clinic. Hypertonic saline solution is appropriate for acute, symptomatic patients with hyponatremia caused by SIADH, nevertheless fluid restriction is advised to chronic symptomless hyponatremia which recommends correcting at a slower rate. When fluid restriction is limited, pharmacological therapy should be a necessary choice. This review summarizes the recent progress of hyponatremia in international guidelines and discusses the defect of hyponatremia managements and the research prospect in the future.

Objective:To explore the mediating effect of self-compassion between family cohesion and loneliness among adolescents.Method:From November to December 2020, a total of 626 adolescents were investigated with the family adaptability and cohesion scale, children loneliness scale and the self-compassion scale short form.Data were analyzed by SPSS 23.0 and PROCESS v 2.16 softwares.The statistical methods included t-test, one-way ANOVA, Pearson correlation analysis and intermediary effect analysis. Results:Compared with girls, boys’ score of family cohesion((63.52±8.47), (65.48±9.07)) was significantly lower but the scores of self-compassion((37.68±5.26), (36.49±5.75)) and loneliness((37.74±10.44), (36.01±10.48)) were significantly higher( t=-2.79, 2.06, 2.70; all P<0.05). There was no significant difference in the scores of family cohesion((63.67±8.71), (64.74±8.85)), self-compassion((37.45±5.71), (36.98±5.49)) and loneliness((36.60±10.52), (36.96±10.49)) between left-behind and non-left-behind children( t=1.29, -0.87, 0.38, all P>0.05). The score of family cohesion of the adolescents from Grade 7 was significantly lower than those of Grade 8, Grade 10 and Grade 11( P<0.01), while the score of self-compassion of the adolescents from Grade 10 was significantly lower than those of Grade 7 and Grade 11(both P<0.01), but the score loneliness of the adolescents from Grade 11 was significantly lower than those of Grade 8 and Grade 10(both P<0.05). Family cohesion(64.50±8.82)was significantly positively associated with self-compassion(37.09±5.54)( r=0.22; P<0.01). Loneliness(36.88±10.49)were significantly negatively associated with self-compassion( r=-0.27, P<0.01) and family cohesion( r=-0.28, P<0.01). The relation between family cohesion and loneliness was partly mediated by self-compassion and the effect of mediation was 20.9%. Conclusion:Family cohesion will not only directly affect the loneliness of adolescents, but also affect loneliness through the mediating effect of self-care.

Objective:To analyze the cognition and willingness of family physicians on contracted service, and to explore the implementation obstacles and feasible strategies of implementing contracted service of family physicians from the perspective of suppliers.Methods:From July to October 2020, 850 family physicians in community health service centers or township health centers in three cities of Shandong Province were investigated by questionnaire survey and key person interview. Descriptive analysis and binary logistic regression model were used to analyze the willingness of family physicians to provide contracted service. Through questionnaire survey and key person interview, the implementation obstacles and service optimization strategies of family physicians were discussed.Results:791 valid questionnaires were obtained, of which 688(87.0%) approved the implementation of family physician contract service, and 679(85.8%) expressed willingness to provide family physician contract service. Marital status, recognition of service policy, satisfaction of service operation effect, optimistic degree of service development prospect and residents′ first choice of illness were the factors influencing family physician′s service willingness.Conclusions:We should effectively improve the family doctor′s service intention and promote the efficient and orderly implementation of family doctor′s contract service policy through enriching policy supporting measures, innovating the application of " Internet plus" , increasing personnel training, optimizing performance appraisal work and creating favorable public opinion environment.

Objective:To understand the willingness of contracted residents to renew the family doctor contract service in Shandong Province, and to explore its influencing factors.Methods:From July to August 2020, 1 500 contracted residents in 3cities of Shandong Province were investigated by questionnaire survey.Descriptive statistical analysis, Mann-Whitney U test and binary logistic regression model were used to analyze the contracted residents′ cognition, utilization, satisfaction evaluation and renewal intention of family doctor contract service. Results:1 445 valid questionnaires were obtained, of which 682(47.2%)were willing to renew their contracts.The results of binary logistic regression analysis showed that marital status, educational level, time to see a doctor in contracted institutions, optimism about the development prospect of contracted service policy, whether the proportion of medical insurance reimbursement increased after signing the contract, whether follow-up work was carried out on time, satisfaction with family doctor service attitude and satisfaction with the effect of disease treatment were factors affecting the willingness of contracted residents to renew the contract.Conclusions:The contracted residents in Shandong Province have a high willingness to renew their contracts. On the basis of consolidating and improving the policy cognition and confidence of the contracted residents, we should actively optimize and improve the contracted service quality, ensure the sense of service access of contracted residents, and continuously and effectively realize the comprehensive promotion of the contracted services of family doctors.

Objective:To explore the current status of medical preventive integration at primary medical institutions, analyze the problems of medical prevention integration, and put forward optimization suggestions.Methods:From June to July 2020, 169 primary medical institutions in a city were selected as the survey objects to conduct a questionnaire survey on the basic information of institutions and the evaluation indicators of medical preventive integration. The evaluation index system of medical preventive integration was divided into a factual survey and a sensory survey. In addition, 32 relevant personnel were interviewed on the current situation of medical preventive integration at primary medical institutions. The reliability and validity of the data were tested and analyzed, while descriptive analysis and classification extraction analysis were carried out.Results:The reliability and validity analysis proved the data reliability. The factual survey extracted three common factors, namely organization management, performance appraisal distribution and information management. The sensory survey extracted two common factors, namely working mode and personnel training. In terms of organization, management and working methods, the degree of medical preventive integration was low. Among them, 53.8% of the institutions had formulated the medical preventive integration norms, and only 41.4% of them had shared residents′ health information in time.Conclusions:The degree of medical preventive integration of primary medical institutions in the city still need to be improved. In the future, we should strengthen the top-level design, establish the norms and cooperation mechanism of medical preventive integration, improve the awareness of medical preventive integration of medical personnel, improve the information level, and to build a new service model integrating disease prevention, medical treatment and health management.

Objective:To evaluate and analyze the patient experience of residents contracted with primary medical institutions, for providing a basis for improving quality of contracted family doctor services.Methods:Using the Chinese version of the primary care assessment tools(PCAT), a household survey was conducted on 1 400 contracted residents in 9 community health service centers and 9 township health centers in a city from May to June 2020, and their medical experience in primary medical institutions was statistically analyzed. At the same time, interviews were conducted with institutional managers and family doctors. Descriptive statistics and one-way ANOVA were used for data analysis.Results:1 333 valid questionnaires were collected, and the effective recovery rate was 95.2%.The total PCAT scoring was 25.17. Seven dimensions of first contact, continuous, coordination, comprehensiveness, patient and family centered, community-oriented and cultural competence scored in average 3.57, 3.68, 3.54, 3.40, 3.72, 3.67 and 3.59 respectively.372 people(47.1%) had not been referred by the contracted institution before going to the superior hospital or specialized hospital. There were significant differences in the scores of four core dimensions in different types of institutions, age, education level, occupation and income( P<0.001). Conclusions:Given the initial progress of contracted family doctor services in the city, there is still room for improvement. It is suggested to further improve the comprehensiveness, coordinationand accessibility of services, and promote the high-quality development of contracted family doctor services.

Objective To systematically analyze the relevant literatures of problem-based learning (PBL) and to provide reference for further improvement and innovation. Methods Using bibliometric method and the package "tm" in R, we searched web of science database for PBL relevant literatures from inception to March 19 of 2018. Results A total of 5710 articles published in 77 journals had been collected. The results showed that PBL relevant literatures were increasing from 1976 to 2018. Most papers were published as article, with first authors from 84 countries of the world. The total citation of 5710 articles is 54768 and the average referenced times is 9.59. The research in those articles focused on medical education, health care sciences and engineering. Conclusions PBL has been widely used in various disciplines, especially in medical education. The research involves a wide range but the quality and depth of the study is still need to be improved.

Objective:To investigate the differences and applicability of free silica detection methods of different crystal forms in dust, and to provide a basis for the selection of various methods.Methods:From December 2021 to June 2022, dust samples from 20 enterprises in different industries in 18 cities in Henan Province were randomly selected as the investigation objects. X-ray diffraction (XRD) method was used to analyze the samples and classify the samples. Based on GBZ/T 192.4-2007 "Determination of Dust in the Air of Workplace-Part 4: Content of Free Silica in Dust", pyrophosphate method and infrared spectrophotometry were used for quantitative determination. The measured results were analyzed by paired sample t test to evaluate the advantages and disadvantages of the two methods and their applicable scope. Results:The XRD results of 20 dust samples could be divided into α, β, γ crystal types and the mixed type of α and γ. There was no significant difference between pyrophosphate method and infrared spectrophotometry ( P=0.180). The pyrophosphate method results of β, γ and α, γ mixed crystalline free silica were significantly higher than those of infrared spectrophotometry, and the difference was statistically significant ( P<0.001) . Conclusion:Pyrophosphate method and infrared spectrophotometry are suitable for α-type free silica, while pyrophosphate method is suitable for β, γ and α, γ mixed crystalline free silica.

Objective:To investigate the differences and applicability of free silica detection methods of different crystal forms in dust, and to provide a basis for the selection of various methods.Methods:From December 2021 to June 2022, dust samples from 20 enterprises in different industries in 18 cities in Henan Province were randomly selected as the investigation objects. X-ray diffraction (XRD) method was used to analyze the samples and classify the samples. Based on GBZ/T 192.4-2007 "Determination of Dust in the Air of Workplace-Part 4: Content of Free Silica in Dust", pyrophosphate method and infrared spectrophotometry were used for quantitative determination. The measured results were analyzed by paired sample t test to evaluate the advantages and disadvantages of the two methods and their applicable scope. Results:The XRD results of 20 dust samples could be divided into α, β, γ crystal types and the mixed type of α and γ. There was no significant difference between pyrophosphate method and infrared spectrophotometry ( P=0.180). The pyrophosphate method results of β, γ and α, γ mixed crystalline free silica were significantly higher than those of infrared spectrophotometry, and the difference was statistically significant ( P<0.001) . Conclusion:Pyrophosphate method and infrared spectrophotometry are suitable for α-type free silica, while pyrophosphate method is suitable for β, γ and α, γ mixed crystalline free silica.