Objective To study the intervention effectiveness of intensive training in medical interns’occupational exposure protection.Methods Medical interns in seven colleges and universities in Wuhan between 2011 and 2015 were chosen and divided into control group (675 medical interns in 2011 - 2013,comprehensive training about healthcare-associated infection control was conducted for once before internship )and intervention group (682 medical interns in 2014 - 2015,hospital-department-tutor three steps of intensive training was conducted),the occurrence of occupational exposure and exposure knowledge awareness between two groups were compared. Results The awareness rate of knowledge about occupational exposure protection and the implementation rate of protective measures in intervention group were both higher than control group (all P <0.05).Incidence of occupa-tional exposure in intervention group was lower than control group (21 .70%[n=148]vs 65.33%[n=441 ],χ2 =262.91 ,P <0.01);percentage of interns who conducted active serological virus detection and intensified vaccination of hepatitis B virus were both higher than control group (14.66%[n=100]vs 2.96%[n=20];11 .73%[n=80]vs 2.67%[n=18],respectively).Occupational exposure before and after intervention occurred most frequently when interns were preparing medicine,occupational exposure reporting rate in intervention group was higher than control group (72.97%[108/148]vs 50.11 % [221/441 ],χ2 =52.78,P <0.01 ).Conclusion The intensive training of occupational exposure protection among medical interns can improve the awareness and skills of occupational protec-tion,and reduce the occurrence of occupational exposure.

Studies have shown that pregnant women due to their specificity and social factors during pregnancy, maternal mortality and postpartum serious complications were significantly higher. Taking effective measures to control maternal mortality and ensuring the safety of pregnant women is an urgent problem to be solved.The first measure to ensure the safety of pregnant women is to use appropriate assessment tools, accurate, dynamic and comprehensive risk assessment of pregnant women. At present, with the start of a comprehensive two-child policy,research related to obstetric early warning scores has become the focus of research in the field of obstetric care.Therefore,this article through the"obstetrics","maternal","risk warning","risk score"as the key word,search Wanfang database,Chinese Journal full-text database(CNKI),Chinese biomedical literature database(CBM);foreign language literature,such as PubMed,Web of Science,Springer,EBSCO and other databases,with"early warning score","risk score","risk score system","Obstetric","Obstetric care"Word for retrieval.So that to provide a comprehensive analysis of the status quo of the use of early risk assessment tools at home and abroad,and to summarize the contents of the assessment tools,and further point out the problems in the current research.

Health education during pregnancy can reduce the incidence of maternal and child disease and improve their health level. As the implementation of the " universal two-child policy" and the change of the national fertility view, the number of maternal, especially the number of the advanced maternal age, is faster increase.While the health manpower in our country is short, so we need a convenient, fast and safe informationalizedway for maternal health education.This article comprehensive analyze the status of application health education about the form and content in the China and overseas,and discuss the advantages and limitations, in order to establish a scientific, effective, propagable and new model of maternity information health education, to provide experience and enlightenment for our clinical works.

Objective:To use Meta analysis to understand the prevalence of the heritability of body mass index (BMI) in twins.Methods:All studies on the heritability of the twins' BMI published before December 31, 2020 were retrieved through the China National Knowledge Network, Wanfang, VIP, PubMed and Web of Science databases. The literature quality was evaluated by using Joanna Briggs Institute Critical Appraisal tools. Stata 16.0 was used to perform subgroup analysis on the outcome indicators (heritability, 95% CI) to explore the source of heterogeneity. The local weighted regression method was used to fit the trend of heritability with age. The publication bias test and the sensitivity analysis of included literatures were also performed by using Stata 16.0. Results:A total of 10 articles meeting the inclusion and exclusion criteria were included with 79 twins' independent estimates of heritability for BMI. Meta-analysis showed that the combined value of BMI heritability was 0.69 (95% CI: 0.65-0.71), the combined value of BMI (0.68, 95% CI: 0.65-0.70) in males was lower than that (0.70, 95% CI: 0.68-0.72) in females. The heritability of BMI (0.72, 95% CI: 0.68-0.76) in childhood and adolescence was higher than that (0.68, 95% CI: 0.66-0.70) in adulthood. The gender specific difference in BMI heritability in twins ≤18 years old was even greater, which was lower in males (0.68, 95% CI: 0.61-0.76) than in females (0.75, 95% CI: 0.69-0.81). The heritability increased with age in childhood, reached peak at about 18 years old, and then slowly decreased with age. Conclusions:The heritability of BMI varied with population characteristics, especially age and gender. In view of the high estimated value of BMI heritability in female children and adolescents, more attention should be paid to the start time of health intervention.

?? [Abstract]? Objective? To construct a prenatal care information platform based on "Five-color Management" to improve the health of pregnant women. Methods? From January to February 2018, we selected 152 pregnant women under perinatal care in obstetrical outpatient department and 138 medical workers in obstetrical department at three Class Ⅲ hospitals in He'nan as subjects. Platform contents and functions were determined by literature review, questionnaire survey and expert group meeting. Questionnaire survey adopted the method of convenience sampling. Results? The recovery rate of the pregnant women version and doctor-nurse version of platform content and function demands questionnaire was 97.37% and 98.57% respectively. The plan first draft was developed based on questionnaire survey. Finally, the platform set three-level management content, five color grade and eight function modules by rounds of expert group meeting. Conclusions? The prenatal care information platform has a strict construction method and highly accords with the demands of pregnant women and doctor-nurse. The platform has a strong operability which realizes the high-efficient management for pregnant women and improves the health of pregnant women.

Objective:To develop a family-involved institutional care behavior scale for the elderly and provide a tool for assessing the status quo and level of long-term institutional care for the elderly involving the family.Methods:From December 2018 to July 2019, based on the theory of balance and responsibility sharing and the conceptual model of family participation, the dimensions and item pools of the family-involved institutional care behavior scale for the elderly were constructed through literature review, semi-structured interviews and expert group meetings. Totally 18 experts from 11 provinces and cities in China related to this field were selected, and the Delphi method was used to conduct two rounds of consultations by correspondence. The active coefficient, authoritative coefficient, Kendall's W of experts, and the coefficient of variation, the importance score of items, the full score rate were calculated. Results:In the first and second rounds of consultations by correspondence, the positive coefficients of the experts were 90% and 100%; the authority coefficient was 0.925; and the Kendall's W were 0.160 and 0.287, respectively (both P<0.01) ; the coefficients of variation were 0.10-0.31 and 0.05-0.24; the importance score of items were 3.67-4.78 and 3.78-4.97. Finally, the family-involved institutional care behavior scale for the elderly including 6 dimensions and 35 items were constructed. Conclusions:The construction of the family-involved institutional care behavior scale for the elderly is reliable and robust, which can provide a reference for further developing the content of family participation in care institutions for the elderly and improving the quality of life in the elderly.

Objective:To understand the reasons for non-adherence of pulmonary rehabilitation exercise in patients with acute exacerbation of COPD, and in order to provide theoretical and practical basis for improving patient adherence.Methods:Using qualitative phenomenological research methods, eighteen patients of non-adherence with exercise were conducted deeply semi-structured interviews, and the Colaizzi analysis was used for data analysis and extracting themes.Results:Seven themes were extracted: effect of subjective and objective symptoms, limited by comorbidity, negative mood disturbance, lack of perception effect, material environment in ward, cultural environment in ward and inappropriate form of exercise.Conclusions:Health care providers should value these obstacles and implement targeted measures, in order to achieve the goal of improving exercise adherence, so that more patients would complete pulmonary rehabilitation exercise.

Objective To investigate whether the mechanism of action of electro-acupuncture in MPTP-induced Parkinson's disease(PD)model mice is related to neuroinflammation mediated by the forkhead box protein O1(FoXO1)/NOD-like receptor heat protein structural domain-related protein 3(NLRP3)signaling pathway.Methods Thirty mice were randomly divided into control(Ctrl),model(MPTP),and electro-acupuncture(EA)groups,with 10 mice in each group.PD mouse model was prepared by intraperitoneal injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)30 mg/(kg·d)for 7 d consecutively.Behavioral changes of mice were observed by open field and pole-climbing experiments;α-synuclein(α-syn)expression in the substantia nigra of the midbrain was observed by immunohistochemistry;FoXO1,NLRP3,ASC,and Caspase-1 were deter-mined by Western blot;and the expression of inflammatory factors such as tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)was detected by ELISA in the substantia nigra of the midbrain.Results Mice in the MPTP group showed significant behavioral deficits,with a significant increase in midbrain substantia nigra α-syn(P＜0.01),elevated levels of Iba-1,FoXO1,NLRP3,ASC,and Caspase-1 proteins(P＜0.05 and P＜0.01,respectively),and a significant increase in the levels of TNF-α,and IL-1β(P＜0.01).The treatment of EA was effective in improve the dyskinesia of PD mice,improve motor balance and coordination(P＜0.01),reduce the abnormal aggregation of α-syn(P＜0.01),reduce the abnormal activation of microglia,and alleviate neuroinflammation(P＜0.05).Conclusion Electro-acupuncture may play a protective role in PD by modulating FoXO1/NLRP3 pathway-mediated neuroinflammation.

As a new diagnosis and treatment decision-making model,shared decision making(SDM)can effective-ly solve the problem of patient compliance in the diagnosis and treatment of thoracic tumors,balance the status of both doctors and patients,and gradually get attention and application in the clinical practice of thoracic surgery.The application of SDM in the diagnosis and treatment of thoracic tumors is conducive to improve doctors'diagnosis and treatment level and alleviating the pressure of responsibility,reduce patients'psychological pressure and improve patients'compliance and also improve medi-cal trust and reduce doctor-patient conflict.Due to the limited medical literacy and autonomy of patients,the time for diagnosis and treatment is short due to the imbalance of doctor-patient ratio.Meanwhile,due to the limited sample size of existing stud-ies,SDM model cannot be proved to have a clear gain for the treatment of thoracic tumors,and the implementation of SDM model still faces resistance.In the future,the development of auxiliary decision-making system and the improvement of doc-tors'humanistic care ability will be conducive to promote the practical application of SDM model in thoracic surgery.

Thoracic surgery encompasses the diagnosis and treatment of various chest diseases such as lung cancer,esophageal cancer,and mediastinal tumors.The treatment plans for these diseases are complex and often involve a combina-tion of surgery,chemotherapy,and radiotherapy,each with different impacts on the patient's quality of life.Patient-reported outcomes(PRO)and shared decision-making(SDM)are becoming increasingly important in this field.PRO allows patients to directly report their health status and the effects of treatment,aiding doctors in adjusting treatment plans.SDM ensures that treatment plans align with the patient's personal values and preferences through information sharing and joint decision-making.The comprehensive application of PRO and SDM can enhance patient satisfaction and treatment outcomes,though it also faces challenges such as data collection and time management.Future research should focus on developing more efficient PRO tools and SDM processes to improve patient-centered healthcare quality.