Objective To reduce infection risk in hemodialysis patients through analyzing the causes of over stand-ard colony forming unit(CFU)and conducting bacteriological detection of hemodialysis concentrated B solution. Methods According to microbial monitoring results of hemodialysis concentrate B solution in a hospital between November 2011 and May 2012,disinfection frequency of B solution was changed and dispensing container was covered during the process of using,four groups were divided according to different measures (group A disinfected twice a week,covered dur-ing the process of using;group B twice a week;group C once a week;group D once every two weeks),monthly bacte-riological detection of B solution was conducted,condition before and after disinfection of four groups were com-pared.Results Bacterial count in group A,B ,C and D was(25.41 ±15.08),(28.24±28.04),(68.58 ±22.58), and (75.25±26.63)CFU/mL,respectively (F =79.00,P <0.01 );bacterial count of group A,B,and C after in-tervention were all lower than group D before intervention (all P <0.01),bacterial count of group A and B was the lowest.The qualified rate of group A was 100.00%,the unqualified rate of group B,C,and D was 13.95%, 24.24%,and 35.94% respectively(χ2 =28.70,P <0.01 ),the unqualified rates of group A,B,and C after inter-vention were all lower than group D.Conclusion Hemodialysis concentrated B solution should be used within 24 hours after preparing,disinfected twice a week,and covered during the process of using ,so as to control B solution colony number within the standard level.

Objective To investigate the effect of at-RA in macrophage accumulation in tubulointerstitium of rats with renal tubulointerstitial fibrosis.Methods Unilateral ureteral obstructive(UUO) rat animal models were used for the study.40 SD rats were randomly divided into 5 groups: sham group,UUO group,benazepril group,low-dose at-RA groups and high-dose at-RA groups.The rats were under intragastric administration by benazepril(10mg/(kg?d)) in benazepril group,and by(at-RA)(10mg/(kg?d)) in low-dose at-RA group and 20mg/(kg?d) in high-dose at-RA group and by sodium chloride in tales doses in sham group and UUO group from the day before the operation to 14 day after operation.Immunohistochemistry staining of CD68 and Col Ⅲ was used to define the macrophage accumulation and expression of interstitial Col Ⅲ.The degree of tubulointerstitial damage was scored by HE and Masson staining.Results Tubulointerstitial macrophage infiltration were all significantly reduced by(at-RA) or benazepril treatment.They also improved the histological changes of UUO rats and inhibited interstitial colⅢ deposition.Conclusion Reduction of interstitial macrophage infiltration may be an important event by which(at-RA) or benazepril prevents renal injury caused by UUO.

Objective:To investigate the clinical efficacy of the folding lateral position fixation frame with adjustable angles.Methods:A total of 60 patients from the Department of Intensive Care Unit (ICU) between January and June in 2019 with consciousness disorder or sedation and no ability to change postures on their own were selected and randomized into treatment group ( n=30) and control group ( n=30). Patients in the treatment group were backed by the fixation fame in lateral position of 80 degrees, while those in the control group were backed by sponge triangle pillow in lateral position of 80 degrees. After 2 hours, the angles of the mattress surface and the body of patients in two groups were measured with a SanNiang digital angle ruler. The efficacy rates of maintaining lateral positions of patients in both groups were calculated. The occurrence rates of skin ulcers in both groups were observed as well. Results:The efficacy rate of maintaining a lateral position was 93.3% (28/30) in the treatment group and 33.3% (10/30) in the control group. The differences between two groups were statistically significant ( χ2 value was 23.25, P=0.000). No skin ulcers were observed in patients in the two groups. Conclusion:The folding lateral position fixation frame with adjustable angles helps to maintain the lateral position efficiently, which can smooth sputum drainage, reduce the imbalance between ventilation and blood flow, increase oxygenation and prevent pulmonary infection. Compared with sponge triangle pillow, the frame can bear more weights, which is suitable for patients with varying weights. Beside, the frame is small in size and foldable, which is convenient for storing and sterilizing. It is highly cost effective and can meet different clinical needs.

Purpose: This study aimed to investigate reproductive concerns among breast cancer patients of reproductive age, analyze the influencing factors, explore the relationship between coping styles, fear of progression (FOP), and reproductive concerns, and identify the multiple effects of coping styles on the relationship between FOP and reproductive concerns among Chinese breast cancer patients. Methods: A cross-sectional, descriptive study was conducted among breast cancer patients in four tertiary grade A hospitals in Fujian, China, from January 2022 to September 2022. A total of 210 patients were recruited to complete paper-based questionnaires, which included the general data questionnaires, the Reproductive Concerns After Cancer Scale (RCACS), the Fear of Progression Questionnaire-Short Form (FOP-Q-SF), and the Medical Coping Modes Questionnaire (MCMQ). Structural equation models were utilized to evaluate the multiple effects of coping styles on FOP and reproductive concerns. Results: Reproductive concerns in breast cancer patients had a mean score of 53.02 (SD, 10.69), out of a total score of 90, and coping styles for cancer (confrontation, avoidance) were closely associated with FOP and reproductive concerns. FOP showed a significant positive correlation with reproductive concerns (r = .52, p < .01). At the same time, confrontation was significantly negatively correlated with both FOP (r = −.28, p < .01) and reproductive concerns (r = −.39, p < .01). Avoidance was positively correlated to both FOP (r = .25, p < .01) and reproductive concerns (r = .34, p < .01). The impact of FOP on reproductive concerns is partially mediated by confrontation and avoidance, with effect sizes of .07 and .04, respectively. These mediating factors account for 22.0% of the total effect. Conclusions The FOP directly impacted reproductive concerns, while coping styles could partially mediate the association between FOP and reproductive concerns. This study illustrates the role of confrontation and avoidance in alleviating reproductive concerns, suggesting that it is necessary to focus on the changes in reproductive concerns among reproductive-age breast cancer patients. Healthcare professionals can improve disease awareness and reduce patients' FOP, thereby promoting positive psychological and coping behaviors and ultimately alleviating reproductive concerns.

Objective To construct a curriculum system for higher vocational education in speech-language-hearing rehabilitation based on the World Health Organization rehabilitation competency framework(RCF),to align with international standards. Methods Based on RCF,curriculum theory and principles of vocational education psychology,a curriculum system and its content for higher vocational education in speech-language-hearing rehabilitation were developed.The curric-ulum content and core competencies were analyzed in detail across four levels:basic courses,specialized basic courses,specialized core courses and practical training courses. Results From the perspective of the seven competency domains of RCF,the theoretical and practical significance of con-structing a speech-language-hearing higher vocational education curriculum system based on RCF was systemati-cally elaborated.The study emphasized the importance of establishing competency-oriented higher vocational re-habilitation education for developing students'professional competence,adapting to job requirements,and pro-moting career development.A curriculum content system for speech-language-hearing rehabilitation higher voca-tional education based on RCF was systematically constructed,encompassing basic courses,professional cours-es,and practical training courses.The course names,main content and competency objectives at each level were analyzed in detail. Conclusion It is important to develop the course system of higher vocational education of speech-language-hearing reha-bilitation based on RCF.By comparing with international standards,the curriculum is optimized,focusing on im-proving students'vocational competence and promoting the international development.The curriculum system covers key areas such as core values,beliefs,practice and professionalism,integrates basic,core and practical training courses to achieve a competence-oriented curriculum system for higher vocational speech-language-hear-ing rehabilitation education.

To address the issue that the existing weakly supervised segmentation methods have difficulties in obtaining fine-grained glandular features from colorectal pathological images,leading to the inability to generate high-quality pseudo-labels and compromising the gland segmentation performance,a dual-branch network based on weakly supervised learning is proposed for gland segmentation in colorectal pathological image.The patch-level colorectal pathological images are input into the first branch network,where the interaction and fusion of local and global features of patch-level images are achieved through the feature interaction module and affinity attention fusion module,and fine-grained glandular features are obtained.Subsequently,image-level colorectal pathological images are input into the second branch network,where the gland locations are located using the partial class activation attention module,and coarse-grained class activation maps are obtained.Finally,high-quality pseudo-labels are derived from the fine-grained glandular features and coarse-grained class activation maps,and gland segmentation is realized in the segmentation network through the cross-scale connected spatial perception module.The tests on two colorectal pathological image datasets(GlaS and CRAG)reveal that the proposed method is superior to other segmentation methods in segmentation performance,confirming its effectiveness.

High-precision segmentation of melanoma images is crucial for early diagnosis and improving patient survival.However,the blurring of the edge region of melanoma,which presents irregular shapes,makes it difficult for existing segmentation methods to obtain edge feature information,affecting the accuracy of melanoma image segmentation.To solve this problem,a melanoma image segmentation method based on edge key points and edge attention is proposed.An edge key point selection module for point rendering and a combined convolution transformer block are designed in the encoder to guide the acquisition of local and global features of the edge by selecting edge key points.Then,the edge refinement module is designed in the encoder to refine the edge features of the deep network,and finally,the multi-scale edge attention module is designed in the skip connection,which enables the capture of the edge shape features at multiple scales.The tests on two datasets(ISIC 2018 and PH2)demonstrate that the proposed method has better segmentation performance than the existing segmentation methods.

Objective Using three models too estimate excess mortality associated with influenza of Shanxi Province during 2013-2017. Methods Mortality data and influenza surveillance data of 11 cities of Shanxi Province from the 2013-2014 through 2016-2017 were used to estimate influenza?associated all cause deaths, circulatory and respiratory deaths and respiratory deaths. Three models were used: (i) Serfling regression, (ii)Poisson regression, (iii)General line model. Results The total reported death cases of all cause were 157 733, annual death cases of all cause were 39 433, among these cases, male cases 93 831 (59.50%), cases above 65 years old 123 931 (78.57%). Annual influenza?associated excess mortality, for all causes, circulatory and respiratory deaths, respiratory deaths were 8.62 deaths per 100 000, 6.33 deaths per 100 000 and 0.68 deaths per 100 000 estimated by Serfling model, respectively; and 21.30 deaths per 100 000, 16.89 deaths per 100 000 and 2.14 deaths per 100 000 estimated by General line model, respectively; and 21.76 deaths per 100 000, 17.03 deaths per 100 000 and 2.05 deaths per 100 000, estimated by Poisson model, respectively. Influenza?related excess mortality was higher in people over 75 years old; influenza?associated excess mortalityfor all causes, circulatory and respiratory deaths, respiratory deaths were 259.67 deaths per 100 000, 229.90 deaths per 100 000 and 32.63 deaths per 100 000, estimated by GLM model, respectively; and 269.49 deaths per 100 000, 233.69 deaths per 100 000 and 31.27 deaths per 100 000, estimated by Poisson model,respectively. Conclusion Excess mortality associated with influenza mainly caused by A (H3N2), Influenza caused the most associated death amongold people.

Objective Using three models too estimate excess mortality associated with influenza of Shanxi Province during 2013-2017. Methods Mortality data and influenza surveillance data of 11 cities of Shanxi Province from the 2013-2014 through 2016-2017 were used to estimate influenza?associated all cause deaths, circulatory and respiratory deaths and respiratory deaths. Three models were used: (i) Serfling regression, (ii)Poisson regression, (iii)General line model. Results The total reported death cases of all cause were 157 733, annual death cases of all cause were 39 433, among these cases, male cases 93 831 (59.50%), cases above 65 years old 123 931 (78.57%). Annual influenza?associated excess mortality, for all causes, circulatory and respiratory deaths, respiratory deaths were 8.62 deaths per 100 000, 6.33 deaths per 100 000 and 0.68 deaths per 100 000 estimated by Serfling model, respectively; and 21.30 deaths per 100 000, 16.89 deaths per 100 000 and 2.14 deaths per 100 000 estimated by General line model, respectively; and 21.76 deaths per 100 000, 17.03 deaths per 100 000 and 2.05 deaths per 100 000, estimated by Poisson model, respectively. Influenza?related excess mortality was higher in people over 75 years old; influenza?associated excess mortalityfor all causes, circulatory and respiratory deaths, respiratory deaths were 259.67 deaths per 100 000, 229.90 deaths per 100 000 and 32.63 deaths per 100 000, estimated by GLM model, respectively; and 269.49 deaths per 100 000, 233.69 deaths per 100 000 and 31.27 deaths per 100 000, estimated by Poisson model,respectively. Conclusion Excess mortality associated with influenza mainly caused by A (H3N2), Influenza caused the most associated death amongold people.

Objective To explore the efficacy of self-made adjustable tracheal cannula in obese patients with tracheotomy. Methods A corresponding model of tracheal cannula was taken and cut with a length of 16 cm. It is noted that the inflation catheter of the airbag should not be broken. A further trim was done along the longitudinal side of the inflation catheter. The inflation catheter was retained. A rubber cork from a nutrient solution bottle was chosen, and a hole was trimmed with the same length of the diameter of the tracheal cannula, through which the tracheal cannula was put. A disposal oxygen mask was trimmed into two wings like a butterfly, the middle of which was made into a hole with the same length of the diameter of the tracheal cannula. Two rectangular holes were made on the two wings in order to fit the rubber cork. The fixed wings of and rubber cork were put together through sutures. The other end of the tracheal cannula was cut and put on a connector and sterilized with ethylene oxide in the supply room. The intraoperative method was the same as the conventional tracheotomy. After the cannula was inserted, the length of the cannula was adjusted by moving the rubber cork up and down according to the obesity of the patient′s neck. Results Compared with regular tracheal cannula, the self-made adjustable tracheal cannula could be easily inserted into the trachea of patients no matter how obese their necks were. It could be connected to ventilator, keep patient′s airway clear and effectively drain phlegm. No slippage was observed in our practice. It was simple, accessible and lower in cost. Conclusions The application of self-made adjustable tracheal cannula in obese patients with tracheotomy can meet the clinical therapeutic needs, and it also proves to be affordable for patients.