Objective To investigate whether the effect of PBL is better than LBL when used in a new type of three phases labor trainee teaching. Methods 216 medical students of the five-year and seven-year program who took part in labor trainee in the 2013-2014 school year were chosen and divided into two groups:PBL group and LBL group. Both the two groups' labor trainee were performed as three phases: trainee preparation, delivery room trainee, and discussion-class after trainee. Ques-tionnaire investigations were used to evaluate the effect of the delivery room trainee and discussion-class in PBL group and LBL group. A quiz after the third phase was used to examine whether the teaching effect of the two groups is different or not. Statistical analysis was performed using SPSS 16.0 software. Count data between sample rates were compared by chi square test, mean data between the two groups were compared by t test, the inspection level is α=0.05. Results Both in the delivery room trainee and discussion-class after trainee, questionnaire score in PBL group was significantly higher than that in LBL group (P<0.05). The average of quiz score in PBL group was 25.7±2.1, which was significantly higher than that in LBL group (19.3±3.6) (P<0.05). The excellent rate in PBL group was 82.6%, which was also higher than that in LBL group (P<0.05). Conclusion PBL teaching method elevates learning initiative of medical students and increases the teaching effect, and it can be promoted in labor trainee teaching.

Objective To analyze the diagnostic value of serum procalcitonin ( PCT ) for early postoperative bacterial infection after pediatric living donor liver transplantation.Methods A retrospective study was conducted in pediatric patients after living donor liver transplantation recipients admitted to department of critical care medicine of Beijing Friendship Hospital affiliated to Capital Medical University during June 2013 to October 2015.According to the clinical data , all pediatric patients were divided into infection group(n=60) and non-infection group (n=100).Primary disease, PCT post operation day 1 to day 5 for non-infection group and day 1 to day 9 for infection group , temperature , white blood cell , cold ischemia time, warm ischemia time, operation time, volume of blood loss during operation were recorded.All parameters above were compared between groups.Receiver operating characteristic ( ROC) curve was plotted, and the diagnostic value of PCT was evaluated.Results PCT of both groups were elevated after liver transplantation , there was a markedly resolution in non-infection group within 48 to 72 hours.PCT of pediatric patients with bacterial infection was significantly higher than that of non-infected patients , and the difference was of greatly significant (4.62 ±1.39) ng/ml vs (0.85 ±0.19) ng/ml,t=26.56,P=0.00.ROC curve showed that the peak level of PCT might be valuable in the diagnosis of bacterial infection ( AUC=0.985).There was no significant difference of cold ischemia time [(109.92 ±19.22) min vs (108.04 ± 13.20) min, t=1.05, P=0.29], warm ischemia time[(1.49 ±0.17) min vs (1.52 ±0.12) min, t=1.08, P=0.28], operation time[(8.01 ±0.77)vs (8.00 ±1.05) h, t=0.06, P=0.94], WBC[(8.95 ±1.69) ×109/L vs (8.98 ±2.00) ×109/L,t=-0.08, P=0.93]and body temperature[(37.5 ±0.7) vs (37.5 ±0.8) ℃,t=-0.05, P=0.96] on the first day after surgery between infection and non-infection groups.Amount of bleeding in infection group was higher than that of non infection group [ ( 650.87 ± 90.36) ml vs (240.29 ±67.67) ml, t=32.33, P=0.00], there was longer length of ICU stay in the infection group[(11.01 ±1.81)d vs (6.03 ±1.65)d, t=17.78, P=0.00].Conclusion Peak PCT level was a valuable indicator for early postoperative bacterial infection after pediatric living donor liver transplantation.

Objective To investigate the epidemiological characteristics and mortality risk factors of severe sepsis patients admitted into intensive care unit (ICU).Methods The clinical data of 419 severe sepsis patients admitted to an adult ICU of Beijing Friendship Hospital from January 2009 to December 2012 were retrospectively analyzed and evaluated.Logistic regression analysis was employed to identify independent risk factors for the death of patients with severe sepsis during ICU stay.Results Overall ICU mortality was 43.9％ (184/419),and the respiratory tract was the most common site of infection (50.8％),followed by infection of the gastrointestinal tract and abdominal cavity (27.8％),and hematogenous infection (4.3％).Gram-negative bacteria were the most common pathogens [46.0％ (214/465)].Iatrogenic infections accounted for 53.7％ (225/419) of the enrolled patients.Logistic regression analysis showed that age [odds ratio (OR)=0.003,95％ confidence interval (95％CI) 1.015-1.056,P=0.O00],vasoactive drug application (OR=3.251,95％CI 1.562-6.768,P=0.002),failure of 3 or more organs (OR=2.452,95％ CI 1.015-5.924,P=0.046),and iatrogenic infection (OR =1.775,95％ CI 0.981-3.221,P=0.046) were independent risk factors for ICU mortality.Conclusions Severe sepsis is a common cause of ICU admission.Patients with risk factors for high mortality should be carefully monitored,and aggressive treatment should be administered.

Objective To study the inhibitory action of docetaxel (DOC) on the proliferation of HeLa and SiHa cells. Methods Cell morphological changes were observed with inverted phase contrast microscope. MTT was adopted to test and calculate the cell inhibition ratio. Flow cytometry was used to detect cell cycle. Results DOC had an obvious concentration-dependent inhibitory effect on the proliferation of both HeLa and SiHa cells. The inhibition ratio of DOC on SiHa was significantly higher than that on HeLa (P<0.05). DOC blocked HeLa at G2/M phase. Under the effect of DOC, the cell cycle of SiHa was not changed much. Conclusion DOC has an obvious inhibitory action on both HeLa and SiHa cells, which shows a promising prospect of DOC in clinical treatment of cervical cancer.

Objective: To clarify the association between occupational exposure to wood dust and chronic obstructive pulmonary disease risk by a meta-analysis. Methods: A systematic search of the studies was conducted using 3 English databases (Pubmed, Embase, and Cochrane library) and 3 Chinese databases (CNKI, WanFang, and VIP) before March 2019. The following key words was used: 1) wood, 2) hardwood, 3) softwood, 4) saw, 5) dust, 6) chronic obstructive pulmonary disease, 7) chronic obstructive airway disease, 8) lung function. A quality score was evaluated by Newcastle-Ottawa Scale, NOS (Wells, 2012). Pooled effect value with 95% confidence interval (CI) was calculated using fixed-effect model (Heterogeneity test I²<25%) or random-effect model (Heterogeneity test I²≥25%). Meta-regression was used to explore heterogeneous source. Sensitivity analysis was used to verify the stability of the results. Publication bias was assessed by Egger＇s test. Fill and trim method was used to correct the pool effect value with 95%CI for studies which wit publication bias. The TSA threshold was calculated by the O＇Brien-Fleming loss function in the TSA data. The studies were evaluated based on the accrued information size (AIS) . Results: A total of 9 studies were included in the analysis. The occupational exposure to wood dust was not significantly associated with increased chronic obstructive pulmonary disease risk (ES=1.01, 95%CI: 0.856-1.194). TSA showed that the cumulative Z-value curve neither gone beyond the traditional (Z=1.96) threshold line, nor exceed the TSA threshold, but has reached the expected amount of information. This result was consistent with the meta-analysis. Conclusion This study does not yet consider that COPD is associated with occupational wood dust exposure.

Objective: To investigate the influence of depression symtoms and related occupational stress on workers in chip manufacturing industry. Methods: By using cluster sampling method, 2 251workers in electronic manufacturing industry were selected as study subjects in July-December 2016. The simple Occupational Stress Questionnnaire and The Chinese version of Effort-reword imbalance questionnaire (ERI) Questionnnaire were used to investigate and evaluate their job demand-control-support questionnaire (JDC) and ERI Occupational stress stiuation respctively. Depression symptoms were measured by the depression module of the patient health questionnaire (PHQ-9) . Results: Among the 2 251 workers, 77.03% workers were found high level of depression symptom.486 workers were the highest level depression.1 248 workers were the higher level depression. The scores of depression symptoms in the related influceing factors JDC and ERI occupational stress were different (P<0.05) . The multivariate logistic analysis results indicated the main positve factors of depression were above college degree, more than 1 years of working age and high input (P<0.05) . The main protective factors of depression were non migrant workers and high return (P<0.05) . Conclusion The rate of depression of workers is relatively higher in chip manufacturing factory. Enterprises should pay special attention to workers who were above college degree, more than 1 years of working age and high input, ERI occupational stress.

Objective:To explore the main influencing factors of leucopenia in benzene workers.Methods:The data of 514 benzene hazardous enterprises and 97 non benzene hazardous enterprises in 16 municipal districts of Tianjin from January to December 2019 were collected. A total of 16113 benzene exposed workers and 5817 non benzene exposed workers were included in the study. The occupational health examination data of workers during on-the-job were analyzed, and they were divided into white blood cell count reduction group and white blood cell count normal group. Additive interaction was used to evaluate the effects of workers' general situation, occupational history, enterprise information and benzene exposure on leukocyte count reduction.Results:The age and length of service of workers in the white blood cell count reduction group were higher than those in the white blood cell count normal group ( Z=-3.411, -4.539, P<0.01) . The detection rate of white blood cell count reduction in women was higher than that in men (χ 2=211.631, P<0.01) . The detection rate of white blood cell count reduction in workers in enterprises located in urban areas, classified as manufacturing and small and micro enterprises was higher than that in workers in suburbs, non manufacturing and large and medium-sized enterprises (χ 2=8.039, 4.232, 37.478, P<0.05) . The additive interaction analysis of the influencing factors of white blood cell count reduction showed that there was additive interaction between gender and benzene exposure, the relative excess risk ratio ( RERI) , attribution ratio ( AP) and interaction index ( S) were 3.789 (95% CI: 2.280-5.299) , 0.571 (95% CI: 0.414-0.726) and 3.045 (95% CI: 1.699-5.459) , respectively. Conclusion:The management of benzene operation in the production environment of small and micro manufacturing enterprises in Tianjin should be strengthened, as well as the personal protective articles and occupational health protection measures for female operators, so as to protect the health of operators and prevent the occurrence of occupational diseases.

Objective:To explore the main influencing factors of leucopenia in benzene workers.Methods:The data of 514 benzene hazardous enterprises and 97 non benzene hazardous enterprises in 16 municipal districts of Tianjin from January to December 2019 were collected. A total of 16113 benzene exposed workers and 5817 non benzene exposed workers were included in the study. The occupational health examination data of workers during on-the-job were analyzed, and they were divided into white blood cell count reduction group and white blood cell count normal group. Additive interaction was used to evaluate the effects of workers' general situation, occupational history, enterprise information and benzene exposure on leukocyte count reduction.Results:The age and length of service of workers in the white blood cell count reduction group were higher than those in the white blood cell count normal group ( Z=-3.411, -4.539, P<0.01) . The detection rate of white blood cell count reduction in women was higher than that in men (χ 2=211.631, P<0.01) . The detection rate of white blood cell count reduction in workers in enterprises located in urban areas, classified as manufacturing and small and micro enterprises was higher than that in workers in suburbs, non manufacturing and large and medium-sized enterprises (χ 2=8.039, 4.232, 37.478, P<0.05) . The additive interaction analysis of the influencing factors of white blood cell count reduction showed that there was additive interaction between gender and benzene exposure, the relative excess risk ratio ( RERI) , attribution ratio ( AP) and interaction index ( S) were 3.789 (95% CI: 2.280-5.299) , 0.571 (95% CI: 0.414-0.726) and 3.045 (95% CI: 1.699-5.459) , respectively. Conclusion:The management of benzene operation in the production environment of small and micro manufacturing enterprises in Tianjin should be strengthened, as well as the personal protective articles and occupational health protection measures for female operators, so as to protect the health of operators and prevent the occurrence of occupational diseases.

Objective: To analyze the characteristics and influencing factors of new occupational diseases in Tianjin from 2008 to 2017, and to provide scientific basis for the formulation of prevention and control measures for occupational diseases in Tianjin. Methods: In 2018, data on the new occupational disease in Tianjin from 2008 to 2017 were collected from the China Disease Prevention and Control Information System. Statistical analysis was performed on the basic situation, the nature of the company, and the distribution of the industry. Results: A total of 5201 cases of occupational diseases were reported in Tianjin from 2008 to 2017, mainly including pneumoconiosis (92.37%) , followed by occupational poisoning (2.88%) , and the third occupational ENT disease (2.31%) . The male cases were higher than females, with a median age of 56 years and a median of 20 years of service. The most reported area was Hedong District (26.86%) . The economic type and scale of the cases belonged to state-owned large and medium-sized enterprises. The industry is mainly composed of non-metallic mineral products, and there are significant differences in the composition ratios of its economic type (χ²=19240.00, P<0.01) , enterprise size (χ²=3883.00, P<0.01) and industry (χ²=52050.00, P<0.01) . Conclusion Pneumoconiosis, occupational poisoning and occupational ENT diseases are the key prevention and control occupational diseases in Tianjin city. It is necessary to strengthen the prevention and control of occupational diseases in large and medium-sized state-owned enterprises, and to respond to occupational disease hazards in such key industries as the manufacturing industry so as to protect the health of occupational groups.

Objective:To understand the present situation, law and characteristics of pesticide poisoning in Tianjin, and provide scientific basis for the formulation of pesticide poisoning control strategy.Methods:In August 2019, the related pesticide poisoning report card was derived from the China Disease Prevention and Control Information System. A total of 864 pesticide poisoning cases from 2009 to 2018 in Tianjin were studied, and the data were processed by SPSS 24.0, statistical analysis was performed by 2-test.Results:from 2009 to 2018, a total of 56 pesticide poisoning deaths were reported in Tianjin, with a case fatality rate of 6.48% (56/864) , including 166 cases of productive pesticide poisoning (19.21%) and 698 cases of non-productive pesticide poisoning (80.79%) , the difference of case fatality rate was statistically significant (χ 2=11.72, P<0.05) . With the most cases of pesticide poisoning (144 cases) in 2012 and the least (48 cases) in 2018. The cases were mainly distributed in Jizhou (312 cases) , Baodi District (247 cases) and Jinnan district (140 cases) , with a total of 699 cases (80.90%) . The time was mainly from May to August, in which non-productive pesticide poisoning occurred in each month, the concentration of productive pesticide poisoning occurred from April to August in spring and summer, and reached its peak in July and August. The age range from 35 to 44 years old was the most (188 cases, 21.76%) , and the age below 15 years old was the least (8 cases, 0.93%) . Pesticide was the most common drug type (551 cases, 63.77%) . Conclusion:The departments concerned should strengthen the education and supervision of pesticide safety, improve the farmers'awareness of harm and self-protection, so as to reduce and prevent the occurrence of pesticide poisoning in this city.