Objective To find out the cognition understanding of iodine deficiency disorders(IDD) of target population in Xi’an City, and evaluate the effectiveness of a health education project on prevention and control of IDD. Methods By using the random number table, three towns in each project county were selected. Obeying the requirements of the education program for IDD control, the health education activities were implemented during 2007 - 2011. Before and after intervention, questionnaire was used to investigate the intervention effect. The primary school grade 5 students and women of childbearing age were included in the survey of IDD knowledge. Hierarchical random sampling method was used to select pupils and childbearing women. Results After health education, the rate of knowledge on IDD increased from 66.97%(13 321/19 890) to 93.49%(18 610/19 905,χ2 = 4 413.07, P < 0.05) among pupils, and 62.27%(6 193/9 945) to 93.96%(9 361/ 9 963, χ2= 2 924.18, P<0.05) among childbearing women. And the awareness had reached the national standard. But the survey results showed that: the rate of IDD related knowledge in rural areas was lower than that in town areas. The awareness rates of IDD in precaution, main hazards, identification of iodized salt were 46.50%(239/514), 55.25%(284/514) and 50.97%(262/514) among pupils in rural areas and 61.44%(376/612), 65.69%(402/612) and 70.59%(432/612) among pupils in town areas, and the awareness rates of pupils in rural areas were lower than those of pupils in town areas. Thirty-six point ninety-three per cent(226/612) of the pupils in towns and 35.60%(183/514) of the pupils in rural areas told this information to their parents. The awareness rates of IDD in precaution, main hazards, IDD prevention day were 49.25%(197/400), 50.75%(203/400) and 36.50%(146/400) among women in rural areas and 75.44%(298/395), 80.25%(317/395) and 57.97%(229/395) among women in town areas, and the rates of women in rural areas were lower than those of women in town areas. The rate of consciously purchasing of qualified iodized salt was 51.75%(207/400) and the consumption rate of iodized salt was 36.75%(147/400) among women in rural areas, which were 73.42%(290/395) and 43.80%(173/395) among women in town areas, and the rates in rural areas were lower than those in town areas. Conclusions Before health education of IDD, the rate of IDD related knowledge in Xi’an City is poor, rural areas are lower than town areas. Health education project is effective in promoting the understanding and grasp of IDD knowledge.

Objective To investigate the significance of "merge" model versus "traditional" model in rotation training for professional clinical postgraduate students in department of gastroenterology. Methods The professional clinical postgraduate students who underwent rotation training in Qingdao Municipal Hospital from July 2012 to July 2016 were enrolled as subjects and were trained with the"merge" model and the "traditional" model, respectively. The two groups of subjects were compared in terms of clinical knowledge , skills , and core competencies . Results The postgraduates trained by the"merge" model had a significantly higher total score of clinical examinations than those trained by the"traditional" model [(92.60±2.52) vs. (83.80±3.14), t=10.93, P<0.01], while there were no significant differences in professional quality and doctor-patient communication between the two groups. Compared with those trained with the"traditional"model, the postgraduates trained by the"merge"model had significantly better understanding of clinical knowledge and clinical thinking ability, diagnosis and treatment skills, and psychological quality (χ2=27.00, 10.23, and 12.21, all P<0.01);however, there was no significant difference in clinical research ability between the two groups (χ2=1.39, P=0.24). Conclusion The model of professional clinical postgraduate training combined with standardized training of residents is superior to the traditional training model, and compared with the "traditional" model, the "merge" model is more beneficial to the training of comprehensive clinical practice abilities and thus holds promise for further application.

Sixty general practitioners of in-service training undertaking rotation in gastroenterology department of Qingdao Municipal Hospital from July 2017 to July 2019 were randomized assigned in trial group ( n=30) and control group ( n=30). The problem-oriented mode was applied in trial group and conventional mode was applied in control group for teaching of two typical digestive diseases (upper gastrointestinal bleeding and acute pancreatitis). The formative evaluation and questionnaire survey were used to compare the teaching effects and the results of evaluation were compared with χ 2 test by SPSS 17.0 between two groups. The excellent and good rates of evaluation for the clinical psychological quality, clinical reasoning ability, doctor-patient communication ability and practice-based learning and improvement ability in trial group were significantly higher than those in the control group(χ2=7.38, P=0.03; χ2=12.96, P<0.01; χ2=23.33, P<0.01; χ2=16.14, P<0.01). Questionnaire survey showed more satisfaction towards teaching method in trial group was higher than that in control group(χ2=12.86, P<0.01); and the clinical reasoning ability, learning initiative and self-confidence in trial group were improved more markedly than those in control group(χ2=8.26, P=0.02; χ2=19.48, P<0.01; χ2=21.46, P<0.01). The problem-oriented clinical thinking teaching model demonstrates good effects on clinical comprehensive ability for general practitioners of in-service training during gastroenterology rotation, which is worth further promotion.

OBJECTIVE: To determine whether or not detailed cystic feature analysis on CT scans can assist in the differential diagnosis of pancreatic ductal adenocarcinoma (PDAC) from serous cystadenoma (SCN), mucinous cystadenoma (MCN), and a pseudocyst. MATERIALS AND METHODS: This study received Institutional Review Board approval and informed patient consent was waived. Electronic radiology and pathology databases were searched to identify patients with PDAC (n = 19), SCN (n = 26), MCN (n = 20) and a pseudocyst (n = 23) who underwent pancreatic CT imaging. The number, size, location, and contents of cysts, and the contour of the lesions were reviewed, in addition to the wall thickness, enhancement patterns, and other signs of pancreatic and peripancreatic involvement. Diagnosis was based on lesion resection (n = 82) or on a combination of cytological findings, biochemical markers, and tumor markers (n = 6). Fisher's exact test was used to analyze the results. RESULTS: A combination of the CT findings including irregular contour, multiple cysts, mural nodes, and localized thickening, had a relatively high sensitivity (74%) and specificity (75%) for differentiating PDAC from SCN, MCN, and pseudocysts (p < 0.05). Other CT findings such as location, greatest dimension, or the presence of calcification were not significantly different. CONCLUSION: The CT findings for PDAC are non-specific, but perhaps helpful for differentiation. PDAC should be included in the general differential diagnosis of pancreatic cystic neoplasms.
Adenocarcinoma/pathology/*radiography ; Adolescent ; Adult ; Aged ; Cystadenocarcinoma, Serous/pathology/*radiography ; Cystadenoma, Mucinous/pathology/*radiography ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Pancreatic Neoplasms/pathology/*radiography ; Retrospective Studies ; Sensitivity and Specificity ; *Tomography, X-Ray Computed ; Tumor Markers, Biological/analysis

Objective To observe the effect of yin-tonifying and fire-removing prescription on IL-10 and IL-18 in systemic lupus erythematosus patients with syndrome of internal heat due to yin deficiency.Methods A total of 86 systemic lupus erythematosus patients with syndrome of internal heat due to yin deficiency were enrolled and randomly divided into control group and research group,43 cases in each group.The control group was treated with conventional western medicine,while research group was treated with yin-tonifying and fire-removing prescription on basis of control group.The TCM symptom score,serum IL-10 and IL-18 levels and the incidence rate of adverse reactions were compared between the two groups.The clinical efficacy of the two groups was evaluated.Results Mter treatment,the levels of IL-10 and IL-18 in both group decreased significantly,and the levels in research group were significantly lower than control group (P ＜ 0.05).The total effective rate was 95.35％ in research group,which was significantly higher than 69.77％ in the control group (P ＜ 0.05).The incidence rate of adverse reactions was 6.98％ in the research group,whichwas similar to 9.30％ in the control group (P ＞ 0.05).Conclusion For systemic lupus erythematosus patients with syndrome of internal heat due to yin deficiency,yin-tonifying and fire-removing prescription can significantly improve the clinical efficacy,alleviate clinical symptoms,and will not increase the incidence rate of adverse reactions.

Objective To observe the effect of yin-tonifying and fire-removing prescription on IL-10 and IL-18 in systemic lupus erythematosus patients with syndrome of internal heat due to yin deficiency.Methods A total of 86 systemic lupus erythematosus patients with syndrome of internal heat due to yin deficiency were enrolled and randomly divided into control group and research group,43 cases in each group.The control group was treated with conventional western medicine,while research group was treated with yin-tonifying and fire-removing prescription on basis of control group.The TCM symptom score,serum IL-10 and IL-18 levels and the incidence rate of adverse reactions were compared between the two groups.The clinical efficacy of the two groups was evaluated.Results Mter treatment,the levels of IL-10 and IL-18 in both group decreased significantly,and the levels in research group were significantly lower than control group (P ＜ 0.05).The total effective rate was 95.35％ in research group,which was significantly higher than 69.77％ in the control group (P ＜ 0.05).The incidence rate of adverse reactions was 6.98％ in the research group,whichwas similar to 9.30％ in the control group (P ＞ 0.05).Conclusion For systemic lupus erythematosus patients with syndrome of internal heat due to yin deficiency,yin-tonifying and fire-removing prescription can significantly improve the clinical efficacy,alleviate clinical symptoms,and will not increase the incidence rate of adverse reactions.

OBJECTIVE: To evaluate the prognostic value of ultrasonographic measurement of optic nerve sheath diameter (ONSD) and ONSD/eyeball transverse diameter (ETD) ratio in stroke patients during hospitalization. METHODS: Adult patients with stroke (ischemic stroke or hemorrhagic stroke) admitted to department of critical care medicine of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from November 2017 to November 2018 were enrolled. On the day of admission, ONSD and ETD (retina-retina at 3 mm behind the globe along) were detected by ultrasound, the ONSD/ETD ratio was calculated, and the baseline data and outcomes were recorded. Patients were divided into survival group and death group according to their survival status. Locally weighted scatterplot smoothing (LOWESS) and the receiver operating characteristic (ROC) curve were used to calculate the thresholds of ONSD and ONSD/ETD. The correlation between ONSD, ONSD/ETD and prognosis were assessed. RESULTS: Thirty-eight of 83 patients (45.8%) survived and were discharged from the hospital, while 45 patients died (54.2%). There were significant differences in Glasgow coma score (GCS), shifting of the middle structure, ONSD and ONSD/ETD between the death group and the survival group [GCS: 4.7±2.8 vs. 11.0±3.2, shifting of the middle structure (mm): 5.8±5.9 vs. 1.3±2.6, ONSD (mm): 5.5±0.4 vs. 4.4±0.5, ONSD/ETD: 0.25±0.02 vs. 0.20±0.02, all P < 0.05]. LOWESS and ROC curve analysis suggested thresholds of ONSD and ONSD/ETD for predicting adverse prognosis of stroke patients were 5.0 mm and 0.25, respectively. By adjusting the influence of confounding factors on prognosis, a prediction model based on ONSD was established, and the ROC curve was drawn. The area under the curve (AUC) was 0.978, the optimal predictive point of the model was 0.870, the sensitivity was 89%, and the specificity was 100%. The ONSD/ETD prediction model was also obtained, and the AUC was 0.988, the optimal prediction threshold of the model was 0.768, and the sensitivity for predicting adverse clinical prognosis was 94%, and the specificity was 97%. The stability of ONSD/ETD was better than that of ONSD. ONSD coefficient of variation was 0.14, and ONSD/ETD coefficient of variation was 0.13. CONCLUSIONS ONSD and ONSD/ETD were significantly correlated with the prognosis of critical patients with stroke. The mortality increased significantly in patients with an ONSD greater than 5.0 mm and ONSD/ETD greater than 0.25. ONSD and ONSD/ETD may be promising tools for early assessment of clinical outcomes in these patients.
Adult ; China ; Hospitalization ; Humans ; Intracranial Pressure ; Optic Nerve ; Prognosis ; ROC Curve ; Stroke ; Ultrasonography

Objective By measuring the nursing staffs′psychology of work adaptability and engagement before and after the utilization of hemodialysis information system, multidimensional comparative analysis was used to compare the differences of nursing staffs′ psychology between before and after the utilization of hemodialysis information system. Methods To select nursing staffs working in the Sixth People′s Hospital Affiliated Shanghai Jiaotong University, the nursing staffs were investigated by work attitude scale ( WA) and Utrecht work engagement scale ( UWES) before the implementation of hemodialysis information system. The collected data was statistically analyzed by SPSS 19. 0. Results Before the implementation of hemodialysis information system, score of WA was (20. 79 ± 3. 39), and the differences of nursing staffs in different age group had statistical significance (P <0. 01); the differences were statistically significant in WA scores of nursing staffs with different educational background after 4, 6 and 10 weeks implementation of hemodialysis information system (P<0. 05); the differences were no statistically significant in different work experiences between before and after implementation of the system (P>0. 05). The score of UWES was (48. 53 ± 9. 02) before usage of the system;when staffs had different age, education background and length of work experience, the differences had statistical significance (P >0. 05). Conclusions Hemodialysis information system can reduce obstacles of nursing staffs′ work adaptability working in Hemodialysis Room, enhance work engagement and achieve digital, scientific and modernized nursing service, so as to provide a safe and comprehensive quality nursing service for hemodialysis patients.

Objective: To evaluate the prognostic value of ultrasonographic measurement of optic nerve sheath diameter (ONSD) and ONSD/eyeball transverse diameter (ETD) ratio in stroke patients during hospitalization. Methods: Adult patients with stroke (ischemic stroke or hemorrhagic stroke) admitted to department of critical care medicine of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from November 2017 to November 2018 were enrolled. On the day of admission, ONSD and ETD (retina-retina at 3 mm behind the globe along) were detected by ultrasound, the ONSD/ETD ratio was calculated, and the baseline data and outcomes were recorded. Patients were divided into survival group and death group according to their survival status. Locally weighted scatterplot smoothing (LOWESS) and the receiver operating characteristic (ROC) curve were used to calculate the thresholds of ONSD and ONSD/ETD. The correlation between ONSD, ONSD/ETD and prognosis were assessed. Results: Thirty-eight of 83 patients (45.8%) survived and were discharged from the hospital, while 45 patients died (54.2%). There were significant differences in Glasgow coma score (GCS), shifting of the middle structure, ONSD and ONSD/ETD between the death group and the survival group [GCS: 4.7±2.8 vs. 11.0±3.2, shifting of the middle structure (mm): 5.8±5.9 vs. 1.3±2.6, ONSD (mm): 5.5±0.4 vs. 4.4±0.5, ONSD/ETD: 0.25±0.02 vs. 0.20±0.02, all P < 0.05]. LOWESS and ROC curve analysis suggested thresholds of ONSD and ONSD/ETD for predicting adverse prognosis of stroke patients were 5.0 mm and 0.25, respectively. By adjusting the influence of confounding factors on prognosis, a prediction model based on ONSD was established, and the ROC curve was drawn. The area under the curve (AUC) was 0.978, the optimal predictive point of the model was 0.870, the sensitivity was 89%, and the specificity was 100%. The ONSD/ETD prediction model was also obtained, and the AUC was 0.988, the optimal prediction threshold of the model was 0.768, and the sensitivity for predicting adverse clinical prognosis was 94%, and the specificity was 97%. The stability of ONSD/ETD was better than that of ONSD. ONSD coefficient of variation was 0.14, and ONSD/ETD coefficient of variation was 0.13. Conclusions ONSD and ONSD/ETD were significantly correlated with the prognosis of critical patients with stroke. The mortality increased significantly in patients with an ONSD greater than 5.0 mm and ONSD/ETD greater than 0.25. ONSD and ONSD/ETD may be promising tools for early assessment of clinical outcomes in these patients.