Objective: To examine the correlation between anxiety and perceived stress among medical personnel in a tertiary specialized cancer hospital, so as to provide the evidence for improving psychological health among medical personnel. Methods: In-service doctors, nurses and technicians were sampled from a tertiary specialized cancer hospital, and their demographics, perceived stress and sources of stress were collected using self-designed questionnaires. Anxiety was evaluated using the Self-rating Anxiety Scale (SAS), and the associations of anxiety with perceived stress and source of stress were examined using a multivariable logistic regression model. Results: A total 800 questionnaires were allocated and 655 valid questionnaires were recovered, with an effective recovery rate of 81.88%. The respondents included 160 men (24.43%) and 495 women (75.57%), and 297 respondents (45.34%) were at ages of 30 to 39 years. There were 14 respondents with no or low level of stress (2.14%), 245 with general level of stress (37.40%), 289 with high level of stress (44.12%), and 107 with extremely high level of stress (16.34%). The prevalence of anxiety was 36.64% among respondents. Multivariable logistic regression analysis identified perceived stress at work (OR=2.205, 95%CI: 1.657-2.675), doctor-patient relationship (OR=2.259, 95%CI: 1.561-3.282) and interpersonal relationship (OR=2.272, 95%CI: 1.387-3.693) as a factor affecting anxiety among medical personnel. Conclusion The anxiety correlates with stress at work, doctor-patient relationship and interpersonal relationship among medical personnel in a tertiary specialized cancer hospital.

Objective To observe the effect of recombinant human mannose-binding lectin (RhMBL)on the expression of Bcl-2 and p53 gene in thyroid cancer cell lines.Methods Two kinds of thyroid cancer cell lines( K1 cells and FTC-133 cells) were dealed with different concentrations of rhMBL( control group:0 mg/L;experimental group:1 mg/L),then total protein was extracted to detect the expression of Bcl-2 and p53 by Western Blot.Results The expression level of p53 and Bcl-2 were observed to be obviously down-regulated after incubation with RhMBL.( 1 ) K1 cells:There was significant difference on the expression of p53 and Bcl-2 between control group and experimental group [ p53:( 1.51 ± 0.29) vs (0.74 ±0.07),t =7.63 ; P =0.040;Bcl-2:( 1.20 ± 0.07 ) vs ( 0.59 ± 0.04 ),t =6.28,P =0.001 ] ; ( 2 ) FTC-133 cells:there was also significant difference on the expression of p53 and Bcl-2 between control group and experimental group [ p53:( 0.88 ±0.14) vs(0.35 ±0.08),t =3.29,P=0.003; Bcl-2:(1.07±0.11) vs (0.33 ±0.06),t =5.73,P=0.000 ].Conclusion Bcl-2 and p53 may play an important role on the induction of thyroid cancer cell apoptosis and inhibition its proliferation by RhMBL.

Objective To investigate the therapeutic effect of acupoint application combined with Daqinglong Decoction (DD) for children asthma with the syndrome of exterior cold and interior heat. Methods One hundred and five children with mild and moderate persistent asthma were evenly randomized into combination group, DD group and Montelukast group. The three groups were separately given acupoint application combined with oral use of DD, oral use of DD, oral use of Montelukast, respectively. The treatment for the three groups lasted for 12 weeks. The scores of traditional Chinese medical syndromes in the three groups were recorded before and after treatment. The control of asthmatic symptoms, acute asthmatic attack frequency, and the course of disease were evaluated at the end of follow-up week 12. Results (1) At the end of treatment week 4 and 16, the syndrome scores were obviously decreased in the three groups (P<0.05 compared with those before treatment). At the end of treatment week 4, the decrease of syndrome scores in the combination group was superior to that in DD group (P<0.05), but did not differ from that in Montelukast group (P>0.05) . At the end of follow-up week 12, the decrease of syndrome scores in the combination group was superior to that in DD group and Montelukast group (P<0.05). (2) The effect of the combination group on controlling the asthmatic symptoms was superior to that of the other two groups ( P<0.01). ( 3) The combination group had lower acute asthmatic attack frequency and shorter disease course than DD group and Montelukast group ( P<0.01). Conclusion Acupoint application combined with oral use of Daqinglong Decoction is effective for children asthma with the syndrome of exterior cold and interior heat by relieving symptoms, enhancing the control of asthma, reducing acute asthmatic attack frequency and shortening disease course.

Objective To investigate the effectiveness of FOCUS-PDCA model in enhancing the quality of official hospi-tal documents in a Zhejiang-based hospital.Methods The FOCUS-PDCA model was adopted to identify and address the issues present in the hospital's document management system in 2021.An improvement team was established,tasked with identifying the root cause of the poor quality of documents through group ability assessments,critical factor voting,and brainstorming.High-risk,high-frequency,and error-prone issues were prioritized for improvement.The FOCUS-PDCA model,along with tools such as the 5W1 H and Gantt chart,were utilized to continuously enhance the quality of the hospital's official documentation.The pass rate of document preparation pre-and post-improvement was compared using SPSS software.Results After the improvement,the approval rate for hospital document writing increased from 25.4％to 51.2％,exceeding the target value and achieving the antici-pated outcome.The most significant improvement was observed in document formatting,which now adheres to national standards at a 100％standard rate.Conclusion The FOCUS-PDCA model,coupled with measures such as top-level system design,train-ing,and strict auditing,can significantly improve the quality of hospital documentation.This approach effectively enhances the standard of document management within the hospital,contributing to modernization efforts.

Objective This study aims to investigate the effectiveness of hospital-institute integration and collaborative governance between Zhejiang Cancer Hospital and Hangzhou Institute of Medicine,Chinese Academy of Sciences,analyze the specific factors influencing the integration and provide recommendations.Methods Based on the operational status of hospital-institute integration and collaborative governance between Zhejiang Cancer Hospital and Hangzhou Institute of Medicine,Chinese Academy of Sciences,a questionnaire survey was designed.There are a total of 305 participants,who are employees of Zhejiang Cancer Hospital and Hangzhou Institute of Medicine,Chinese Academy of Sciences.Results There is a correlation between"primary factors affecting effectiveness of hospital-institute integration"and"current main problems in the hospital-institute inte-gration",of which determination and understanding of"primary factors affecting effectiveness of hospital-institute integration"are affected by sex,title and education,and that of"current main problems in the hospital-institute integration"by age,position,working years and working years in the hospital;in addition,position also affects the determination and understanding of"actual result and effect of hospital-institute integration on hospital and medicine","evaluation of current advancement of hospital-institu-te integration","role of Hangzhou Institute of Medicine Chinese Academy of Sciences in the hospital-institute integration","un-derstanding related systems and mechanisms of hospital-institute integration".Conclusion Whether they are middle-level cadres or not has an impact on many aspects of the integration of institutions,resulting in difficulties in obtaining information,the need to strengthen incentive measures for some employees,and the need to improve the integration governance system and mechanism.In order to improve the effectiveness of institutional integration and coordinated governance,we propose countermeasures in this paper,such as improving information flows,enhancing employee incentives and strengthening system and mechanism.

ObjectiveTo explore the effect of the serum containing Huanglian Wendantang on pyroptosis in vitro model of insulin resistance and its mechanism. MethodSD rats were randomly divided into two groups， namely Huanglian Wendantang-containing serum group and blank serum group， and given 7.8 g·kg^-1·d^-1 Huanglian Wendantang and equal volume of normal saline by intragastric administration according to body surface area. Blank serum and medicated serum with different concentration were extracted and prepared. HepG2 cells were treated with sodium palmitate to construct the model of insulin resistance （IR）， and they were randomly divided into control group， model group， metformin hydrochloride group， blank serum group， and Huanglian Wendantang-containing serum high-， medium-， and low-dose groups. After 24 h of cultivation， the cells of each group were treated with insulin for 15 min at concentration of 1×10^-7 mol·L^-1， and the cell supernatant was collected. The glucose oxidase （GOD-POD） kit was used to determine the glucose content of each group， and calculate the glucose consumption and inhibition rate. The methyl thiazolyl tetrazolium （MTT） assay was used to detect the cell proliferation， thus screening out the optimal dose of serum containing Huanglian Wendantang. HepG2 cells were randomly divided into control group， model group， and Huanglian Wendantang-containing serum group. The levels of interleukin-1β （IL-1β） and interleukin-18 （IL-18） in each group were determined by enzyme-linked immunosorbent assay （ELISA）， and the mRNA and protein expression levels of NOD like receptor protein 3 （NLRP3） in each group were determined by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot. In terms of the mechanism， HepG2 cells were randomly divided into control group， empty vector group， NLRP3 overexpression group， empty vector + IR group， empty vector + IR + Huanglian Wendantang-containing serum group， NLRP3 overexpression + IR group， and NLRP3 overexpression + IR + Huanglian Wendantang-contain serum group. GOD-POD method was used to measure the glucose content of each group cells， and calculate the glucose consumption. ELISA was used to determine the release of IL-1β and IL-18 in each group. Real-time PCR and Western blot assay were used to determine the mRNA and protein expressions of cysteinyl aspartate specific proteinase-1 （Caspase-1）， gasdermin D （GSDMD）， and NLRP3. Immunofluorescence assay was used to detect NLRP3， GSDMD， and Caspase -1 expressions. ResultAs compared with the control group， the glucose consumption in the model group was significantly decreased （P<0.01）. As compared with the model group， the increase of the glucose consumption of IR-HepG2 cells was the most significant in the Huanglian Wendantang-containing serum high-dose group （P< 0.01）. As compared with the control group， the IL-1β and IL-18 release levels and the mRNA and protein expressions of NLRP3 in IR-HepG2 cells were significantly increased （P<0.05， P<0.01）. Huanglian Wendantang effectively reduced IR-HepG2 cell supernatant IL-1β， IL-18， and NLRP3 mRNA and protein expressions as compared with the model group （P<0.05， P<0.01）. Overexpression of NLRP3 significantly reduced the cell glucose consumption as compared with the control group and the empty vector group （P<0.01）， and significantly up-regulated the IL-1β and IL-18 levels and the mRNA and protein levels of NLRP3， Caspase-1， and GSDMD as compared with the empty vector + IR group （P<0.05， P<0.01）. Huanglian Wendantang-containing serum effectively reversed the above indicators as compared with the NLRP3 + IR group （P<0.05， P<0.01）. ConclusionHigh fat-induced insulin sensitivity of IR-HepG2 cells is closely related to inflammation and NLRP3 expression. Huanglian Wendantang-containing serum improves IR-HepG2 cell pyroptosis through the targeted inhibition of NLRP3/Caspase-1 signaling pathway， which provides new therapeutic targets for the prevention and treatment of IR and type 2 diabetes mellitus （T2DM）.