The concept is cell of the theory. Starting from the concept, is the first and important step in building the modern basic theory of traditional Chinese medicine. Based on the early thought of Changes from phenomenon description to entity elucidation, we firstly introduce conceptual change in this paper and point out its basic meaning and role. To accurately apply the new concept, we have analyzed and demonstrated the concept and its expression object, the concept words' expression forms, as well as the concept explanatory power in details, and pointed out the problems because of ignoring these recognition in researching the concept of chinese medicine and its solutions. We have summarized the laws of the international scientific community realizing the conceptual change focus on the object, explore the unknown, propose new knowledge. and proposed the definition of conceptual change of the basic theory of traditional Chinese medicine. According to preliminary findings we have generalized the goal and standard to achieve the conceptual change of the basic theory of traditional Chinese medicine and gave examples of proof. As such we have draw an conclusion: the concepts of the basic theory of traditional Chinese medicine form the scientific concepts of the modern basic theory of traditional Chinese medicine through conceptual change, and thus guiding the theory, teaching and thinking reform of the Chinese medicine.

Objective To realize the utilization of antibacterial drugs in pediatric inpatients in Children's Hospital for clinical reference of rational use of drugs. Methods By a retrospective study, 180 cases in pediatric inpatients were randomly sampled in Children's Hospital from July to December 2012, and were analyzed in utility rate, antibiotics varieties, administrational frequency,single dose,combination use,prophylaxis time,courses of drug use,etc. Results The use of antibacterial drugs in pediatric inpatients was 110 cases (61.1%) and used in combination was 55 cases (50%) . Leading the list in terms of DDDs was cephalosporins,followed byβ-lactam and its enzyme inhibitor complex preparations. The improper medications frequency was 12 cases (10.9%), irrational single dose was 7 cases (6.4%), and irrational course of treatment was 9 cases (8.2%) . Conclusion The utilization of antibacterial drugs in Children's Hospital is basically rational, but there still exist some irrational drug uses,such as antibiotics varieties,no indication, irrational dosage,long duration and irrational combination. So, it is necessary to enhance the administration of antibiotics use and improve the level of clinical reasonable application of antibiotics.

[Abstract ] Objective Stenosis is a common complication of Crohn′s disease (CD), different treatments for different cau-ses.The article aimed to investigate bowel stenosis by the application of MRI diffusion-weighted imaging(DWI) and explore its value of identifying CD. Methods From Jan 2014 to Jun 2014, 31 patients with histologically proven CD (18 males and 13 females;mean age:38.90 ±13.65 years) were recruited in this approved retrospective study .All patients underwent conventional 3.0T MRI and DWI sequences .According to the most serious stenosis part identified by MRI , DWI sequence examination was added and the apparent diffusion coefficient (ADC) of the lesion was measured.All patients would undergo colonoscopy in 24 hours.According to the endo-scopic manifestations and pathological results , the patients were divided into inflammatory group (n=21) and fibrotic group (n=10). We observed the difference of ADC between two groups and worked out the cutoff points . Results In the inflammatory group , the ADC value andthe mean ADC value of stenosis bowel wall were (1.01 ±1.83) ×103 mm2/s and (1.40 ±0.23) ×103 mm2/s, whereas (0.53 ±1.03) ×103 mm2/s and (0.80 ±0.16) ×103 mm2/s in the fibrotic group(P<0.05).The area under receiver operating characteristic curve was 0.981 (95%confidence interval 0.943-1.000), taking 1.11 ×103mm2/s as the cutoff point.The sensitivity of low ADC values in detecting inflammatory bowels was 90.5%, and the specificity of high ADC values in excluding inflammatory bowels was 100%. Conclusion Different pathological components limit the movement of water molecular at different degrees , therefore quantitative parameters can be acquired by measuring ADCs , which contributes to the identification and diagnosis of CD secondary bowel stenosis.

Objective Visceral pain in patients with inflammatory bowel disease (IBD) may be associated with the abnormal processing of pain in the central nervous system.The aim of the study is to investigate the characteristic changes of brain functions in the IBD patients using resting-state functional magnetic resonance imaging (rs-fMRI) with the amplitude of low-frequency fluctuation (ALFF) algorithm.Methods This study included 27 cases of IBD treated in our hospital from December 2015 to August of 2016 and 21 healthy volunteers as normal controls.We recorded the high-resolution structure imaging and rs-fMRI data, compared the brain activities of the two groups patients by ALFF analysis, and evaluated the correlation of the ALFF values with the clinical parameters of the IBD patients.Results Compared with the normal control group, the IBD patients showed significantly decreased ALFF values in the medial frontal gyrus, right putamen, right insula, left middle cingulate gyrus (MCC), and bilateral supplementary motor region (P<0.05), increased ALFF values in the middle frontal gyrus, left superior frontal gyrus, and medial prefrontal lobe region (P<0.05).The ALFF values in the inferior parietal lobule, precuneus and MCC of the IBD patients were correlated negatively with the blood sedimentation rate (r=-0.537,-0.588, and-0.588, P<0.05), disease course (P<0.05), and C-reactive protein (CRP) level (P<0.05), while that in the medial frontal gyrus positively with the CRP level (r=-0.623, P<0.001).Conclusion IBD patients have abnormal ALFF values in various brain regions, mainly in those involved in the processing of visceral pain and emotion.

OBJECTIVETo understand the incidence rates of agricultural profession-related injuries and the relationship to alcohol consumption.

METHODSA multistage sample of 2366 villagers was selected from Minority Nationality Villages, Heilongjiang province. Face-to-face interviews were conducted by trained interviewers during May 2008. 2198 (92.9%) of the eligible questionnaires were available.

RESULTSIncidence rate of agricultural profession-related injury rate was 11.8% (260/2198) from May 2007 to April 2008. Higher proportions of injuries were seen for males, 30 - 49 year olds, farmers and among those people working on farms for 10 years or more, smoking during farm work, with sleeping disorder, using motor vehicles, and those using agricultural machinery. Rate of alcohol drinking was 29.1% (640/2198) in the month prior to the investigation. Results from logistic regression models showed that alcohol consumption patterns and other alcohol-related behavior were examined in separate logistic models because of collinearity by controlling the variables that were associated with agricultural profession-related injury including sex, age, years of farm work, driving a motor vehicle, and agricultural machinery use etc. In each model, the reference group was those villagers who did not drink in the past month. The odds of injury among villagers with history of past month drinking, who drank distilled spirits, and alcohol drinking at breakfast and lunch were 1.80 (95%CI: 1.24 - 2.62), 2.09 (95%CI: 1.38 - 3.15), 2.15(95%CI: 1.43 - 3.22) respectively. The odds of agricultural injury also significantly increased with greater average amounts of pure alcohol per day, with increased frequency of drinking per week, and reported years of drinking.

CONCLUSIONIntervention efforts should include increasing awareness about alcohol drinking as a major risk factor causing agricultural injuries as well as controlling alcohol drinking, improving knowledge about driving motor vehicle and using agricultural machinery.

Accidents, Occupational ; statistics & numerical data ; Adult ; Agriculture ; Alcohol Drinking ; epidemiology ; Alcoholic Intoxication ; epidemiology ; China ; epidemiology ; Female ; Humans ; Incidence ; Logistic Models ; Male ; Middle Aged ; Minority Groups ; Risk Factors ; Rural Population ; Surveys and Questionnaires

Objective:To study the role of myocardial work parameters in early identification of myocardial injury in neonatal asphyxia.Methods:From July 2020 to December 2021, neonates diagnosed with mild neonatal asphyxia admitted to the Department of Neonatology of our hospital within 24 h after birth were prospectively enrolled into the asphyxia group. Neonates without asphyxia during the same period were selected as the control group and matched with the asphyxia group for gender, gestational age and birth weight at a ratio of 1:1~1:2. The asphyxia group was subgrouped into preterm asphyxia group and term asphyxia group. All neonates received echocardiography within 24 h after birth. Multiple parameters were measured including M-mode, two-dimensional image, Doppler image, global longitudinal strain (GLS) and myocardial work parameters [global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE)]. The level of serum N-terminal pro brain natriuretic peptide (NT-proBNP) was recorded in the asphyxia group. The data were compared between the asphyxia group and the control group. Correlations between myocardial work parameters and other parameters were analyzed.Results:A total of 33 cases were in the asphyxia group and 43 cases were in the control group. The preterm asphyxia group (18 cases) showed significantly lower GWI and GCW than the preterm control group (18 cases) [GWI: (702±153) mmHg vs. (879±205) mmHg, GCW: (1 016±221) mmHg vs. (1 200±271) mmHg] ( P<0.05). No differences existed in GLS, GWW and GWE. The term asphyxia group (15 cases) showed significantly lower GWW than the term control group (25 cases) [45.0 (30.0, 65.0) mmHg vs. 71.0 (35.5,85.5) mmHg] ( P<0.05). No differences existed in GLS, GWI, GCW and GWE. GWI was negatively correlated with serum NT-proBNP level ( r=-0.327, P<0.05). Conclusions:GWI and GCW may indicate myocardial injury in preterm neonates with mild asphyxia.

【Objective:】 To understand the current status of narrative nursing knowledge, attitude, and practice (KAP) among nurses in grade A tertiary hospitals, and to provide a basis for the development of narrative nursing in relevant areas. 【Methods:】 Using convenience sampling methods, 931 nurses from three grade A tertiary hospitals in Xi’an were selected as subjects. A cross-sectional survey was conducted using the Clinical Nurses’ Narrative Nursing Knowledge and Trustworthiness Questionnaire and the General Self-Efficacy Scale. Multiple linear regression analysis was used to explore the influencing factors of nurses’ narrative nursing KAP. 【Results:】 The scores on the three dimensions of narrative nursing KAP were (23.70±2.99) points, (31.69±5.92) points, and (30.26±5.32) points, respectively. Nursing workload, general self-efficacy, professional title, and nursing satisfaction were the influencing factors of nurses’ narrative nursing knowledge dimension (P<0.05). There were statistically significant differences in nurses’ narrative nursing attitude dimension among nursing workload, general self-efficacy, professional title, monthly income, and nursing satisfaction (P<0.05). Nursing workload, general self-efficacy, nursing satisfaction, and accompanying experience were the influencing factors of nurses’ narrative nursing behavior dimension (P<0.05). 【Conclusion:】 Nurses in grade A tertiary hospitals have moderate narrative nursing knowledge, positive attitudes, and poor practice execution. The high nursing workload is the main barrier factor for the current development of narrative nursing. Nursing managers should actively build a diversified training system and guarantee system to boost the development of narrative nursing in clinical nursing work, and further promote the development of narrative nursing concepts.

【Objective】 To analyze the HIV-, HCV- and HBV- NAT yield rate in different areas of Henan province, so as to provide the basis for disease prevention and control as well as the establishment of a unified quality control standard for nucleic acid testing(NAT) in the Henan province. 【Methods】 The number and prevalence of NAT yielding samples with isolated infectious virus, namely HIV, HCV and HBV, in 18 blood stations in Henan province from 2017~2019, as well as the trends were analyzed. The NAT quality of each laboratory and each testing system was analyzed according to the ratio of reactive individual donation(ID) results to reactive minipools(MP). 【Results】 The HBV, HCV and HIV ID-NAT yield numbers in 3 501 251 blood donations were HBV 2 606(74/100 000), HCV 21 (0.63/100 000), and HIV 34(1.00/100 000). The HBV ID-NAT yield rate showed an upward trend in the whole province from 2017 to 2019, while the prevalence of HIV and HCV ID-NAT yield didn′t differ significantly during three years. 5 kinds of NAT detection systems were applied in 18 blood centers. among which Ⅰ, Ⅱ, Ⅳ and Ⅴ were triplex detection systems. 2661 ID-reactive samples were implicated in 5 595 MP-reactive samples, with a resolution rate of 47.56%. The resolution rate of triplex NAT system Ⅰ, Ⅱ, Ⅳ and Ⅳ was 39.63%~47.95%, 40.43%~54.36%, 51.61% and 70.00%~45.45%, respectively. An upward trend in triplex NAT resolution rate was observed in 8 laboratories, i. e.B, D, E, F, I, K, L and Q, and an descending trend in A and C. The NAT system Ⅲ, a ID-NAT system, was used only by laboratory C, presenting a NAT-yield rate of 0.19% (282/145 474) and resolution rate of 46.45% (131/282). 【Conclusion】 The majority of NAT-yield of one infectious virus in Henan province is HBV, presenting annual increasing trend. The quality management of NAT laboratories should be strengthened as the divergence was seen in the performance of different NAT laboratories.

【Objective】 To analyze the cause of single-ELISA reactive of four blood screening items in 18 blood stations in Henan, so as to provide the basis for improving the quality of blood screening. 【Methods】 The single-ELISA reactive rate of HBsAg, anti-HCV, HIV Ag/Ab and anti-TP of 18 blood station laboratories in Henan throughout 2019 was calculated, and the causes were analyzed according to different ELISA reagent combinations and gray area settings in each laboratory. 【Results】 The overall single-ELISA reactive rates of HBsAg, anti-HCV, HIV Ag/Ab and anti-TP were 1.740(2 154/1 237 789), 0.564‰(698/1 237 789), 1.421‰(1 759/1 237 789) and 1.561‰(1 932/1 237 789), respectively, showing significant differences by detection items (P <0.05). Person correlation analysis showed that the single-ELISA reactive rate was independent of the gray area settings.but dependent on laboratories and reagent combinations. The single-ELISA reactive rate of HBsAg, anti-HCV, HIV Ag/Ab and anti-TP in D laboratory was the highest and higher than that in other labs using the same reagent.The laboratories with high HBsAg single-ELISA reactive rate were mostly those using a combination of imported reagents and domestic reagents, including the top 6 laboratories. The laboratories with high anti-HCV single-ELISA reactive rate were mostly those using certain domestic reagents. No obvious rules was noticed by single-ELISA reactive for anti-HIV. Laboratories with high anti-TP single-ELISA reactive rate were mostly those using combination 4. 【Conclusion】 The HBsAg single-ELISA reactive rate was the highest in the four blood screening items of blood station laboratories in Henan. The single-ELISA reactive rate is related to the laboratory itself and the reagent manufacturer, suggesting that laboratory quality control should be strengthened and proper reagent combination should be selected to reduce the waste of blood.