Background and purpose:Colorectal cancer (CRC) is a malignancy which is the third incidence and the fourth mortality in the worldwide. The main reason for the development of CRC is that the changes of genetic and epigenetic causes the tumor suppressor gene methylation silencing. This study aimed to investigate the plasma and stool GATA5 gene promoter methylation was detected in clinical diagnosis of CRC. Methods: To collect the paired plasma and stool specimens of 34 cases of healthy and 43 cases of patients with CRC. Methylation speciifc PCR (MSP) was respectively detected the GATA5 gene methylation levels of GATA5 gene in plasma and stool. And then separately analyzed their correlations with clinical and pathological parameters in gastric carcinoma. Results: The result of MSP showed that GATA5 gene promoter methylation rates in plasma and stool of CRC patients were 60.74%, 76.60%, respectively, were higher than those of healthy persons (6.47%, 32.35%). And the differences were statistically signiifcant (P=0.006 7, P=0.000 2, respectively). GATA5 gene methylation rates in plasma of CRC patients were closely related to clinical stage (P=0.000 5) and lymph node metastasis(P=0.020), while GATA5 gene methylation rates in stool of CRC patients had no signiifcant with clinical and pathological parameters. Conclusion:Detection of faecal GATA5 gene methylation level and supplemented plasma GATA5 gene methylation level can become a simple, non-invasive, sensitive and speciifc method for clinical diagnosis of CRC.

Objective:To investigate the diagnostic value of the promoter methylation of plasma RNF180 gene and its protein ex-pression for the detection of gastric cancer. Methods:Methylation-specific polymerase-chain reaction (MSP) and enzyme-linked immu-no-sorbent assay (ELISA) were performed to detect DNA methylation and protein expression of the RNF180 gene, respectively. The correlations of DNA methylation and protein expression of the RNF180 gene with the clinico-pathological parameters of gastric carcino-ma were then separately analyzed. Results:MSP showed that the methylation rates of the RNF180 gene were 62.75%and 21.88%in the plasma of patients with gastric carcinoma and healthy volunteers, respectively;this result indicated that the two groups significantly differed (P<0.01). The methylation of the RNF180 gene was associated with tumor size, clinical stage, tumor differentiation, lymph node metastasis, and distant metastasis (P<0.05). ELISA results showed that the protein expression of the RNF180 gene [(23.22 ± 1.36)μg/mL] was significantly lower (P<0.01) in the plasma of patients with gastric carcinoma than in the plasma of healthy volunteers [(34.25 ± 2.44)μg/mL]. However, the protein expression of the RNF180 gene was not associated with clinicopathological parameters (P>0.05). Conclusion:The RNF180 gene is expressed at a hypermethylation rate, and the corresponding protein expression level is de-creased in the plasma of individuals with gastric carcinoma. Therefore, RNF180 gene methylation in plasma could be applied to detect microinvasion for the clinical diagnosis of gastric cancer.

OBJECTIVE:To evaluate the effect of clinical antibiotics use special rectification in our hospital. METHODS:100 discharged medical records of typeⅠincision surgery were randomly sampled from our hospital during May in 2010 to Apr. in 2011,May in 2011 to Apr. in 2012,May in 2012 to Apr. in 2013,May in 2013 to Apr. in 2014,totaling 400 records. And then evaluation indicators were analyzed statistically,such as antibiotics use intensity,perioperative DDDs of antibiotics in typeⅠinci-sion surgery,DUI,types of antibiotics during perioperative period,medication time,etc. RESULTS:Since the implementation of clinical antibiotics use special rectification in May 2011,the utilization ratio of antibiotics in typeⅠincision surgery of our hospital decreased from 96% to 33%;DUI decreased from 1.44 to 0.79;while reasonable rate of drug selection increased from 19.8% to 100%,and that of medication time increased from 43.8% to 100%. CONCLUSIONS:Rational medication evaluation indicators in typeⅠincision surgery of our hospital have been improved after the implementation of clinical antibiotics use special rectification.

Objective To analyze the current status and influencing factors of occupational stress among medical staff during major public health emergencies. Methods A total of 491 medical staff in Guangzhou City was selected as the research subjects using a convenient sampling method. The Job Content Questionnaire and Effort-Reward Imbalance Questionnaire were used to evaluate the occupational stress level in the job demand-control (JDC) and effort-reward imbalance (ERI) models among the staff. Results Among the research subjects, the detection rates of occupational stress in JDC and ERI models were 50.1% and 52.5%, respectively. There was no significant difference in the detection rates of occupational stress between the two models (P>0.05). The result of multivariate logistic regression analysis showed that individuals with lower monthly income and longer weekly working hours had a higher risk of occupational stress in both JDC and ERI models (all P<0.05). Staff with night shift, daily sleep time less than six hours, and dissatisfaction with the protective measures provided by the hospital had higher risk of occupational stress than those with no night shift, daily sleep time at least six hours, and satisfaction with the protective measures provided by the work place in JDC and ERI models (all P<0.01). The risk of ERI model occupational stress of personnel who had been exposed to COVID-19 cases or suspected cases was higher than that in those who had not been exposed (P<0.05). Conclusion Medical staff experience a certain level of occupational stress, characterized by both JDC and ERI models, during major public health emergencies. The main influencing factors included personal monthly income, weekly working hours, night shift, sleep time, satisfaction with protective measures and occupational exposure.

Objective:Build a research index performance model with discipline growth evaluation, to evaluate the scientific research performance level of various disciplines in hospital more objectively, fairly and dynamically.Methods:Take the research projects, papers, patents and achievements as the main evaluation indicators and establish the hierarchical and classified scoring standards, to form the weight index evaluation model for the total score, per capita score and growth of the discipline research.Results:Using the growth research index to evaluate the scientific research performance of departments and individual researcher between January 2018 and December 2020. Excellent departments were selected for the top 10% of the scientific research index, those whose scientific research scores increased by more than 20% compared with the previous year were selected as the progressive departments, and the top 1% of individual scientific research scores were selected as the advanced researchers, which were commended and encouraged. For the departments ranked in the bottom 5% or whose scientific research index significantly declined compared with previous year, early warning, guidance and supervision were implemented. Since the implementation of the evaluation system, the research performance of disciplines has been significantly improved, and many achievements were made.Conclusions:This evaluation mode can stimulate the enthusiasm of the disciplines and scientific researchers for entrepreneurship and innovation to set up the standards and promote the continuous improvement of the research capacity of the whole hospital.

Objective To evaluate the clinical efficacy and security of therapeutic endoscopy in colorectal polyps. Methods This study was retrospectively analyzed the clinical characteristics of 259 cases with colorectal polyps which were treated by APC, EMR, ESD,high-frequency electroblationt. Results Of 259 patients, 258 cases were successfully removed. One case can not completely stanch bleeding and turned surgical operation. Four cases were early postopera-tive bleeding, and the bleeding stopped under endoscopic hemostasis. There was one case of perforation which was im-proved after conservative treatment. There was no delayed bleeding, burns, subcutaneous emphysema and other compli-cations. Concludion The endoscopic treatment of colorectal polyps is a simple, cheap, safe, reliable and is suitable for a wide range treatment, which is worthy of clinical application.

Objective To investigate the clinical features,pathogenesis,diagnosis and treatment of neonatal cerebral infarction(NCI)in order to have a further understanding of its clinical features,to enhance therapeutic effica﹣cy and to improve prognosis. Methods The clinical history,head magnetic resonance imaging( MRI)+ diffusion Weighted imaging(DWI)data and folloW－up results of 39 neonates With NCI admitted into the Department of Neonato﹣logy,Gaozhou People＇s Hospital and the Second Affiliated Hospital of Shantou University Medical College from January 2013 to March 2018 Were retrospectively analyzed. Results All the 39 children Were diagnosed as NCI by MRI +DWI,among Which 30 cases(76. 92%)Were full－term infants,and 9 cases(23. 08%)Were premature infants,in Which 61. 54%(24／39 cases)Were males,and 17 cases(43. 59%)Were performed With emergency cesarean section because of umbilical cord around neck,intrauterine distress or maternal pregnancy hypertension respectively. TWenty－five patients(64. 10%)had the history of perinatal hypoxia. The presentation of MRI shoWed 32 cases(82. 10%)of ischemic cerebral infarction and 7 cases(17. 90%)of hemorrhagic cerebral infarction,While middle cerebral artery and its branches Were more susceptible to NCI With a left hemisphere predominance. Sixteen patients(41. 03%)developed convulsions. TWo patients died of purulent meningoencephalitis associated With NCI. One patient gave up treatment in the neonatal period and died 2 days after discharge. One patient died of cerebral palsy and pneumonia at the age of 11 months. Nine cases(31. 03%)developed cerebral palsy,and 2 patients developed speech disturbance so they could not express complex sentences. Conclusions Perinatal hypoxia and emergency cesarean section may be closely related to the incidence of NCI. NCI resulting from purulent meningoencephalitis is more severe and has a Worse prognosis. Considering the facts that NCI usually does not have specific clinical manifestations in the early stage,MRI +DWI,as the gold standard for the diagnosis of NCI,could be performed to facilitate early diagnosis and intervention.

{L-End}Objective To establish the norm of Core Occupational Stress Scale (COSS) for electronic manufacturing industry workers in China. {L-End}Methods A total of 3 049 workers from five electronic manufacturing enterprises in four prefecture-level cities concentrated distribution of the electronics manufacturing industry in China were selected as research subjects using a stratified sampling method. COSS was used to investigate occupational stress levels, and the mean norm, percentile norm and threshold norms were established. {L-End}Results The average score of COSS for the electronic manufacturing industry workers in China was (43.5±7.4) points, and the average scores of social support, organization and reward, demand and effort, and autonomy dimensions were (9.5±3.1), (15.1±3.9), (13.1±3.0), and (5.7±2.0) points, respectively. A total score of 0.0-<47.0 points was determined as no occupational stress, 47.0-<51.0 points as mild occupational stress, 51.0-≤54.0 points as moderate occupational stress, and >54.0 points as severe occupational stress. {L-End}Conclusion The norm of COSS for workers in China's electronics manufacturing industry has been established, which can provide a reference for the evaluation and intervention of their occupational stress levels.

ObjectiveTo explore the role of efficacy evaluation methods in providing evidence for traditional Chinese medicine （TCM） clinical practice guidelines based on a demonstration study of clinical efficacy evaluation of TCM for allergic rhinitis （AR），aiming to enrich the sources of evidence for guideline development. MethodReal-world data of TCM medication for AR were collected and efficacy evaluation was carried out. SPSS 16.0 software was used to calculate the conformity of clinical syndromes，main prescriptions， and medications to the guidelines. Correlation analysis of efficacy and medications was performed according to guideline conformity to compare the differences in medications between real-world clinical applications and current guidelines. ResultA total of 198 cases were collected and the clinical medications were compared with the relevant guidelines for AR. It was found that the clinical syndrome conformity was above 70%，and in addition to the guideline syndrome，there were also syndromes in six meridians and other mixed syndromes in clinical practice. The guideline conformity of the main prescriptions used in clinical practice showed a positive correlation trend with efficacy. There were some differences between the commonly used drugs in clinical practice and those recommended by the guidelines. For example，for lung Qi deficiency and cold syndrome，drugs such as Angelicae Dahuricae Radix， Magnoliae Flos， and Schisandrae Chinensis Fructus were often used. For kidney Yang deficiency syndrome，drugs such as Atractylodis Macrocephalae Rhizoma and Ostreae Concha were often used. For spleen Qi deficiency and weakness syndrome，drugs such as Poria， Cinnamomi Ramulus， and Magnoliae Flos were used. For lung Qi deficiency and cold syndrome in children，drugs such as Chebulae Fructus， Cicadae Periostracum， Zingiberis Rhizoma， and Ginseng Radix et Rhizoma were used. For lung and spleen Qi deficiency syndrome，drugs such as Dioscoreae Rhizoma， Menthae Haplocalycis Herba， Amomi Fructus， and Zingiberis Rhizoma were used. There were also some differences in the commonly used drugs for adults and children. For example，for lung Qi deficiency and cold syndrome，adults often used Angelicae Dahuricae Radix， Magnoliae Flos， and Tribuli Fructus，while children often used Ginseng Radix et Rhizoma， Paeoniae Radix Alba， and Poria. For lung meridian hidden heat syndrome， adults often used Bupleuri Radix， Asari Radix et Rhizoma， Pinelliae Rhizoma， and Xanthii Fructus， while children often used Houttuyniae Herba， Menthae Haplocalycis Herba， Citri Reticulatae Pericarpium， and Massa Medicata Fermentata. ConclusionEffective medication regimens can be screened out based on efficacy evaluation methods，which can help supplement immediate， objective， and clinically relevant evidence of medication for the development of clinical practice guidelines in TCM from the perspective of clinical effectiveness.

ObjectiveTo explore the feasibility and rationality of applying relevant diagnostic and treatment programmes from textbooks as evidence in traditional Chinese medicine （TCM） diagnosis and treatment guidelines， using allergic rhinitis as an example. MethodsTextbooks published from October 1949 to December 2022， as well as TCM diagnosis and treatment guidelines published until December 2022 on allergic rhinitis were searched， and the contents of diagnosis and treatment related to allergic rhinitis were extracted. The similarities and differences between textbooks in different periods， between textbooks in different versions， and between textbooks and guidelines were compared and analyzed. ResultsA total of 12 national planning textbooks on TCM otolaryngology and 4 Chinese medicine diagnosis and treatment guidelines on allergic rhinitis from 1975 to 2021 were included. The evolution of diagnostic and treatment programmes was shown by the textbooks in different periods. Since 2003， syndrome of latent heat in lung channel has been added in the published textbook， and TCM featured therapies， such as nasal packing， intranasal spray were enriched， as well as the contents related to prevention and prognosis. The main syndromes included lung qi deficiency and cold， spleen qi deficiency， kidney yang deficiency， and latent heat in lung meridian. The most common recommended prescriptions were Wenfei Zhiliu Pill （温肺止流丹）， Yupingfeng Powder （玉屏风散） and Cangerzi Powder （苍耳子散）； Buzhong Yiqi Decoction （补中益气汤）， Shenling Baizhu Powder （参苓白术散）； Shenqi Pill （肾气丸） or Zhenwu Decoction （真武汤）； Xinyi Qingfei Decoction （辛夷清肺饮）. A comparison of different versions of textbooks showed that the classification of syndromes was consistent， while the formulas were slightly different. The comparison between different versions of the current textbooks and the guidelines showed that the recommended prescriptions of the textbooks had more Cangerzi Powder， Xiaoqinglong Decoction （小青龙汤）， Zhenwu Decoction， etc.， while TCM featured therapies such as nose blowing， smelling， nasal plugging， nasal washing were enriched， and information on formula modification， prevention and adjustment， prognosis were also added， which can supplement the corresponding evidence for the guidelines. ConclusionTextbooks could serve as a strong supplement for the evidence-based development of TCM clinical guidelines. However， there is still a need for further research on the quality assessment system of textbook evidence to improve the credibility of its applicability of the guidelines evidence.