Objective To compare the diagnostic efficacy of bone scintigraphy and MRI on vertebral metastases in patients with nasopharyngeal cancer (NPC). Methods Forty-seven patients of NPC and clinically confirmed metastatic disease in spine underwent bone scintigraphy and MR examination. The number of involved vertebri diagnosed with two methods were calculated and compared retrospectively. Results A total of 187 vertebral metastases were found in 47 patients, among which 153 (81.82%) were detected with bone scintigarphy and 182 (97.33%) were diagnosed with MRI (χ~2＝23.758, P＝0.000). Conclusion Compared with bone scintigraphy, MRI is superior in detecting vertebral metastases from NPC, and can be used as the first choice for the early diagnosis of spinal metastases from NPC.

Rational distribution of health human resources that can keep,use and manage is the key process to strengthen the rural three-level health service network,and to be sure,the sense of identity plays a pivotal role in it.This study,with qualitative research of sociology and research in historic culture,analyzed the influence of the status quo of social,cultural and historical background on rural doctors as health human resource.Through the field observation and individual in-depth interview,it explored the current condition of relationship mode and interaction way behind village life,analyzed the influences of them upon health human resource,and put forward some suggestions to adapt rural culture environment,following the view of existence determines consciousness of historical materialism.

Objective To study the impact of policy external environmental changes on rural doctors'ranks,and to find out the adaptability between the two.Methods The purposeful sampling method was used to study 84 people of district H in Beijing by means of both field observation and individual in -depth interviews from July to August in 2016.The data acquired was analyzed by qualitative method, and interview results were categorized and analyzed by citing typical expressions of the respondents.In October 2016,rural doctors from 260 village clinics in 14 townships in district H were subject to a basic information survey,by means of general description.Results The changes of village governance model, strength of personal relationship made in adaptation between health policy and policy environment,retained the practice of senior village doctors.These people,though low in competence,were advantageous as being locals(237 of them being in the same village)and for their familiarity with health conditions, namely family disease history and diet habits,of local villagers.At the same time,health policies were not adaptive to the policy environment,as village committees tend to ignore management of doctors.12 of the 21 village leaders were not involved in the management.Conclusions Development of rural doctors ranks is highly challenging as making policies friendly to external policy environment, and the constraints of such environment on health policies deserves more attention.

Objective To understand the influence of family integrated care (FICare) model to the human breastfeeding rate of preterm infants in neonatal intensive care units (NICUs).Method It is a multicenter cluster randomized controlled trail for intervention and prognosis.According to inclusion and exclusion criteria,preterm infants with gestation age 28 ～ 35 weeks in 9 NICUs of tertiary hospitals in 8 provinces in China were enrolled and divided into FICare and control group.Mothers of FICare infants were invited to stay in NICU ward at bedside for no less than 3 hours per day.Under the supervision of nurses,FICare infants'mothers complete 13 items of infants'caring skills including Six-step Hand Washing and hand hygiene,positioning the baby,changing diapers and estimating urine output,skin and mouth caring,kangaroo care and so on.The primary outcome is the human breastfeeding rate.Secondary outcomes include feeding parameters and FICare-related parameters.SPSS 20.0 software is used for the data analysis.Result (1) There were 212 infants and 215 infants enrolled in FICare group and control group,respectively.There was no significant difference between 2 groups in gender,gestational age,birth weight (BW),Z-score of BW,singleton percentage,antenatal steroid completion,diagnosis,day of life (DOL) for starting feeds (P ＞ 0.05).(2) There was no significant difference between 2 groups in DOL for full feeding (P ＞ 0.05).The median age of starting breastfed in both groups was DOL 4.There were 202 cases (87.3％) in FICare group and 80 cases (34.9％) in control group be successfully breastfed.The rate of formula feeding,incidence of nosocomial infection,DOL for regaining BW,decrease of BW AZ score in FICare group was significantly lower than the control group,and the weight gain velocity after regaining BW in FICare group was significantly higher than the control group (P ＜ 0.05).(3) The implementation of FICare and completion of antenatal steroid were the independent protective factors for breastfeeding (OR =27.703,95％ CI 14.531 ～ 52.816;OR =9.496,95％ CI 4.768 ～ 18.912),while nosocomial infection and delayed DOL for starting breastfeeding were the independent risk factors for breastfeeding (OR =0.380,95％CI 0.182 ～0.795;OR =0.847,95％ CI 0.734 ～0.977).Conclusion FICare is significantly beneficial to the breastfeeding rate of preterm infants in NICUs.FICare may decrease the severity of extrauterine growth retardation.

Objective To survey the service status of rural doctors in Beijing suburb.Methods Twenty one village officials,21 rural doctors and 42 local residents from 21 villages in Beijing Huairou district were selected with purposive sampling method as the objects of this qualitative study.The service status of rural doctors was assessed from four aspects:basic public health service,basic medical service,management ability,responsibility and communication ability.Results All the 21 village clinics provided basic public health services,including hypertension management (100.0％),diabetes management (100.0％);11 clinics (52.4％) also provided vaccination services.Eighteen village doctors (85.7％) assisted township health center to provide signing health service,but were lack of knowledge about the types of service the general practitioners (GPs) should provide.The well performed basic medical services among 21 village clinics included diagnosis and differential diagnosis of common diseases in 19 (90.5％) clinics,home visits in 18 (85.7％) and physical examinations in 15 (71.4％),but the service like trauma management,changing dressing,subcutaneous injection,intravenous infusion were performed less well.The top three most satisfied aspects in the medical service were the service attitude (4.14 points),the quality of service (3.98 points) and service time (3.66 points),and the bottom three were equipment facilities,the types and varieties of drug,and the environment of clinics.In aspect of emergency service,7 village doctors (33.3％) would choose self-referral by patients without preliminary on-site emergency treatment,5 (23.8％) would give on-site emergency treatment before self-referral by patients.In aspect of training needs,18 (42.9％) local residents and 9 (42.9％) village officials considered that it was not necessary to provide training for village doctor because of relatively older age.In aspect of patient's satisfaction,21 village doctors (100.0％),21 village officials (100.0％) and 34 villagers (81.0％) considered that the village doctor had a high professional sense of responsibility and medical ethics,and their doctor-patient communication skills were strong.Conclusion The survey reveals the current service status of village doctors in Beijing suburb,and it is necessary to take comprehensive measures to upgrade the competence of village doctors and to improve the quality of service in village clinics.

Objective:To understand the relationship between life style and chronic disease in rural area. Meth-ods:With purpose sampling method,a total of 60 villagers with chronic diseases in 14 administrative villages in 3 townships in H district were conducted field observation and in - depth individual interview. Interview contents in-cluded the chronic disease of villager,villagers' daily eating habits and composition,the living condition,and the medication situation of patients with chronic disease and so on. Results:The surveyed villagers' chronic disease was closely related to life style,and the too long time of leisure and unreasonable diet structure were the core fac-tors. Conclusion:Healthy life style should be combined with the local property and diet custom. It should use the method of "adjusting measures to local conditions" rather than" copying",put forward villager' s acceptable and feasible life style,abandon daily life,diet structure and other behaviors that influence health,and effectively inter-vene the occurrence and development of disease,to truly improve the health level of villagers.

Objective To investigate the sleep quality and related influencing factors in pediatric ICU nurses.Methods The study investigated 332 pediatric ICU nurses from six level three hospitals in Hubei province in April 201 5.The sleep status of the participants were assessed by Pittsburgh sleep quality index (PSQI)rating scale.Results The pooled score was (7.73 ±1 .54)and the scores of all the seven dimensions were higher than the Chinese norm (P <0.05).The PSQI scores of 1 92 participants were no less than eight points,which indicated an existing of sleep disorders.The differences of the sores between different professional title,marriage status,work shift,education,working age,and working environment had statistical significant (P <0.05).Conclusions The sleep quality of pediatric ICU nursing staffs was significantly worse than the general population,especially for co-chiefnurse.Factors including divorce,work shifts,college degree,working age >1 0 years,ward noise >60 dB and illumination >1 00 LUX can worse the situation.

Objective:To evaluate the efficacy and safety of Burosumab in patients with X-linked hypophosphatemic rickets.Methods:Clinical data of 9 children diagnosed with X-linked hypophosphatemic rickets and treated with Burosumab in the Department of Pediatric Nephrology, Anhui Children′s Hospital from November 2021 to September 2023 were retrospectively analyzed, including the general information, clinical manifestations, auxiliary examination, Burosumab treatment and follow-up.Results:Among the 9 cases, there were 5 males and 4 females, with a median age at diagonosis of 2 years. After traditional treatment, the fluctuation of serum phosphorus ranged from 0.7 to 0.9 mmol/L. The median age at the initiation of Burosumab treatment was 2.8 years, and the initial dosage was 0.8 mg/kg, administrated subcutaneously every 2 weeks. The laboratory and imaging indexes were improved after 6 months of Burosumab treatment, and the mean serum phosphorus level increased from(0.81±0.14) mmol/L to(1.02±0.10) mmol/L at 1 month( t=3.85, P=0.001) and(1.14±0.25) mmol/L at 6 months( t=3.58, P=0.002). The average alkaline phosphatase(ALP) level decreased from(509.89±110.10) U/L before treatment to(447.89±106.76) U/L after 1 month( t=1.21, P=0.243). After 6 months, the ALP level significantly decreased to(385.89±60.33) U/L ( t=2.96, P=0.009). The average height percentile increased from 18.42±10.09 before treatment to 26.56±16.59 after 6 months( t=1.26, P=0.227). Rachitis severity scores of both lower limbs ranged from 4.61±1.36 before treatment to 3.06±1.51 after 6 months( t=2.29, P=0.036). No serious adverse events occurred during treatment. Conclusion:Burosumab is safe and effective in treating X-linked hypophosphatemic rickets, exhibiting minimal side effects and significant clinical applicability value.

MicroRNAs (miRNAs) are a class of short, highly conserved, non-coding RNA molecules that regulate gene expression by specific binding to the messenger RNAs (mRNAs). At present, the researches on miRNAs have caused immense global concern, and expression of miR-139-5p plays a significant role in tumorigenesis, metastasis and recurrence, through regulating proliferation, migration, and invasion of cancer cells in lung cancer, esophageal cancer, breast cancer, tongue squamous cell carcinoma, hepatocellular carcinoma, etc. MiR-139-5p has a positive impact on the prognosis of cancer, and it can combine with some chemotherapeutic drugs to reverse resistance and enhance the sensitivity of radiotherapy. It also works in the cells and tissues of other diseases, including nerve cells, and inflammation. This article reviewed the progress of miR-139-5p.

Lung cancer is a disease with high incidence rate and high mortality rate worldwide. Its diagnosis and treatment mode is developing constantly. Among them, multi-disciplinary team (MDT) can provide more accurate diagnosis and more individualized treatment, which can not only benefit more early patients, but also prolong the survival time of late patients. However, MDT diagnosis and treatment mode is only carried out more in provincial and municipal tertiary hospitals and has not been popularized. This article intends to introduce MDT mode and its advantages, hoping that MDT mode can be popularized and applied.